Presentation
Twelve hours history of severe abdominal pain with generalized abdominal tenderness.
Patient Data
There is a large amount of free gas within the peritoneal cavity mainly around the liver outlining the falciform ligament "falciform ligament sign" with associated moderate perihepatic and pelvic effusion.
A focal defect is noted at the anterior antral wall, containing small air bubbles which may indicate a perforated gastric ulcer.
The red arrows indicate the area of probable gastric perforation.
Case Discussion
The clinical presentation and CT features are most consistent with a large pneumoperitoneum secondary to a perforated gastric ulcer which was confirmed at surgery ( 5 mm defect of the anterior wall of the antrum).
Additional contributors: R. Bouguelaa, MD, A. Ramdani, MD
Unable to process the form. Check for errors and try again.