Bowel perforation - pneumoperitoneum

Case contributed by Dr Prashant Mudgal

Presentation

Young adult presented with severe abdominal pain, guarding and rigidity.

Patient Data

Age: 22 years
Gender: Male

Large amount of intraperitoneal air noted bounded by abdominal wall, lateral border of liver and inferior surface of diaphragm.  In conjunction with multiple bowel fluid levels, the findings are suggestive of bowel perforation.

Case Discussion

The patient was brought unconscious with severe abdominal pain. Given that the patient wasn't suitable for a conventional erect chest x-ray, the alternative was a left lateral decubitus shoot through. The patient is positioned left lateral decubitus for approximately 10 minutes, to allow intraperitoneal air in the lesser sac to pass through the foramen of Winslow into the greater sac and accumulate between the lateral liver and abdominal wall margins.

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Case information

rID: 33973
Published: 30th Jan 2015
Last edited: 14th Aug 2019
Tag: pm
Inclusion in quiz mode: Included

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