Case contributed by Assoc Prof Frank Gaillard


Presented with severe central chest pain.

Patient Data

Age: 50 years
Gender: Female



Extensive free gas below the diaphragms. Lungs are clear.

Annotated image

Annotated image

A large amount of gas is seen under both diaphragmatic domes (yellow dotted lines). In the left upper quadrant gas is also seen in the stomach (red dotted line) and splenic flexure of the colon (blue dotted line). 

Case Discussion

This patient did have a CT which demonstrated extensive sigmoid diverticular disease with active inflammation and diverticulitis, accounting for the pneumoperitoneum.  Conservative treatment was followed by sigmoidoscopy for direct visualiation.

How to use cases

You can use Radiopaedia cases in a variety of ways to help you learn and teach.

Creating your own cases is easy.

Updating… Please wait.

 Unable to process the form. Check for errors and try again.

 Thank you for updating your details.