Oral contrast study.
Administration of oral contrast confirms the presence of two duodenal diverticuli. Both diverticuli arise from the medial D2 segment of the duodenum. The more superior diverticulum extends to the level of the porta hepatis.The more inferior diverticulum is associated with a contained perforation at its medial aspect, with contrast entering the contained perforation. Surrounding stranding is unchanged. There are now small locules of intraperitoneal free gas.
Conclusion
Perforation from the inferior duodenal diverticulum confirmed. New intraperitoneal free gas.