Pneumoperitoneum

Case contributed by Anil Kumar Geetha Virupakshappa
Diagnosis certain

Presentation

Obstipation, abdominal distension, and vomiting Peritonitic abdomen? Bowel obstruction + perforation?

Patient Data

Age: 70 years
Gender: Male
x-ray

A small focus of air is noted under the right dome of the diaphragm.

Right central line and NG tube in situ.

ct

Multilevel segmental inflammatory strictures of small bowel loops are noted with upstream obstructive dilatation and perforation.

Apart from this, there is a small right adrenal incidentaloma, uncomplicated sigmoid diverticulosis, and a slight left inguinal hernia.

Case Discussion

The patient has managed acutely in the theater with resection of the pathological segment of the bowel, peritoneal lavage, and anastomosis. The patient improved post-intervention.

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