Perforated gastric ulcer

Case contributed by Henry Knipe
Diagnosis certain

Presentation

Epigastric pain and tenderness.

Patient Data

Age: 20 years
Gender: Female
x-ray

Extensive free subdiaphragmatic gas.

ct

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.

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