Tension pneumoperitoneum

Case contributed by Derek Smith
Diagnosis certain

Presentation

Sudden onset abdominal pain during elective endoscopic investigation. Breathless and tachycardic.

Patient Data

Age: 55
Gender: Female

Erect CXR

x-ray

Significant pneumoperitoneum with displacement of diaphragm, abdominal organs and compression of thoracic structures.

Case Discussion

This patient was immediately taken to theater 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.

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