Sudden onset abdominal pain during elective endoscopic investigation. Breathless and tachycardic.
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Significant pneumoperitoneum with displacement of diaphragm, abdominal organs and compression of thoracic structures.
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This patient was immediately taken to theatre for emergency laparotomy. The transverse colon was found to be the site of a number of micro-perforations which contributed to this presentation.
The patient did not survive.