Few small locules of free intraperitoneal air. Visible ulcer channel arising from the cranial aspect of the gastric antrum with small extraluminal collection. Fluid and stranding in the porta hepatis with hepatic subcapsular collection containing mostly conforming to the right hepatic lobe.
Dilated and inflamed gallbladder, which could represent reactive inflammation given the adjacent perforated ulcer or an additional diagnosis of acute cholecystitis. Calcifications within the gallbladder wall suggesting porcelain gallbladder.
After administration of oral contrast, there is increasing, higher density of the subcapsular fluid and fluid just outside of the lumen of the site of perforation in the cranial aspect of the gastric antrum. For example, Hounsfield units after contrast administration just outside of the lumen of the gastric antrum measures 52 versus 6, and within the hepatic subcapsular collection 29 versus 9. This confirms spillage of ingested oral contrast into the spaces due to ulcer perforation. There is also increasing free intraperitoneal air.