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The stomach is distended and filled with material that contains multiple air bubbles. Note gross thinning of the gastric wall at the fundus and gas within the residual wall of the lower gastric body (arrows). Appearances indicate sloughing of the mucosa and other layers of the wall into the lumen with associated haematoma. Note that the SMA and coeliac axis enhance normally. No other organs show ischaemic change and the small bowel is normal.