Case contributed by Dr Peter Mikula


Two days of abdominal pain, rapidly worsening over the last few hours

Patient Data

Age: 70 years
Gender: Female

Massive quantity of intra-abdominal free gas represents pneumoperitoneum. Gas-fluid level through abdomen with upper parts of liver and spleen visible. Appearances in keeping with hydropneumoperitoneum.

Case Discussion

This patient had a prepyloric perforation of 10 mm diameter due to peptic ulcer disease.

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