There is significant abdominal distension secondary to a large tension pneumoperitoneum.
There is a large volume of free intraperitoneal air, with consequent lateral abdominal wall distension, superior displacement of the diaphragms, and posteroinferior displacement of the solid abdominal organs including hollow visceral organs. The stomach is collapsed with a satisfactorily sited nasogastric tube. Significantly reduced IVC calibre suggesting decreased venous return and likely reduced cardiac output. There is no free intra-abdominal or intrapelvic fluid.
Scattered diverticulosis, with perigastric and pericolonic inflammatory reaction surrounding the splenic flexure with regional gaseous locules, and a suspicion of a likely gastric and/or splenic flexure perforation and acute diverticulitis. The small bowel appears normal and unobstructed.
Multichamber cardiomegaly. Calcified coronary vascular plaque including ventricular outflow track. Physiological superior mediastinal fluid. Bibasilar collapse/ consolidation/ atelectasis.
Multiple irregular splenuncles/ splenosis identified, post previous splenectomy. There is no biliary obstruction, and no calcific cholelithiasis. The renal tracts appear normal. The appendix is present and identified and normal. There is no abdominal or pelvic lymphadenopathy. Dorso lumbar and lumbosacral degenerative change with no occult bony lesions.