CT - Abdomen/Pelvis - performed approximately 4 hours after the x-ray
C+ portal venous phase
C+ portal venous phase
Marked amounts of free fluid (13HU) and gas are demonstrated within the abdomen. Surgical sutures in keeping with a recent subtotal colectomy are noted - ? discontinuous. The rectal contrast falls short of the site of anastomosis. However, the free gas locules are predominantly centred within the left upper quadrant corresponding to the region of anastomosis suggesting this is likely the site of perforation. The segment of bowel opacified by the rectal contrast demonstrates no extraluminal extravasation.
The small and large bowel loops are dilated without evidence of mechanical obstruction in keeping with an ileus.
Large bilateral pleural effusions are associated with almost complete bibasal collapse.
Acknowledgement: Dr Bhaveen Marne.