Case contributed by Mohammad Farghali Ali Tosson
Diagnosis certain


Acute epigastric pain

Patient Data

Age: 65 years
Gender: Male

Minimal free peritoneal air that can be missed but in the post contrast study there is a significant increase in the volume of the free peritoneal air and contrast leak is seen in the subhepatic region. Moderate volume of free peritoneal fluid, and low density hepatic focal lesions.

Case Discussion

The oral contrast phase helped confirm the pneumoperitoneum and the site of bowel leak.

In our case, the leakage was seen in the subhepatic region between the left lobe of the liver and stomach suggestive of peptic ulcer perforation.

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