Presentation
Epigastric pain and tenderness.
Patient Data
Age: 20 years
Gender: Female
From the case:
Perforated gastric ulcer
{"current_user":null,"step_through_annotations":true,"access":{"can_edit":false,"can_download":true,"can_toggle_annotations":true,"can_feature":false,"can_examine_pipeline_reports":false,"can_pin":false},"extraPropsURL":"/studies/36862/annotated_viewer_json?lang=us"}
Extensive free subdiaphragmatic gas.
From the case:
Perforated gastric ulcer
{"current_user":null,"step_through_annotations":true,"access":{"can_edit":false,"can_download":true,"can_toggle_annotations":true,"can_feature":false,"can_examine_pipeline_reports":false,"can_pin":false},"extraPropsURL":"/studies/36863/annotated_viewer_json?lang=us"}
There is a defect at the wall of the stomach adjacent to the left lobe of the liver. Extensive pneumoperitoneum. There is free fluid seen in the pelvis. Uncomplicated cholelithiasis.
Case Discussion
Classic example of gross pneumoperitoneum from a perforated gastric ulcer presenting as subdiaphragmatic free gas on chest x-ray. The patient report recent NSAID and heavy alcohol use.