A 58-year-old man with a history of peptic ulcer disease presents to the emergency department with sudden-onset, severe, generalized abdominal pain that he recalls began while he was eating lunch. On examination, he has marked abdominal rigidity, guarding, and rebound tenderness. An erect chest X-ray is obtained. The structure marked **A** in the diagram shows a crescent-shaped lucency. Which of the following is the most likely diagnosis and primary pathophysiology?
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