Presentation
Right then left shoulder tip pain followed by generalised abdominal tenderness, maximal at the epigastrium. Associated melaena and haematemesis. Hb drop from 120 to 67, pallor. Normotensive and normocardic. Past medical history included gastritis one month preceding, commenced on PPI.
Patient Data
Age: 20 years
Gender: Female
From the case:
Pneumoperitoneum
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Info
Erect chest radiograph demonstrating subdiaphragmatic free gas bilaterally and evidence of the cupola sign.
Case Discussion
This case demonstrates pneumoperitoneum in a young patient with no known risk factors of peptic ulcer disease. The patient underwent urgent laparoscopy and was found to have a perforated gastric ulcer.
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