CT
Scout view: A large amount of pneumoperitoneum, oval-shaped air lucency outlined the whole peritoneum and falciform ligament giving the appearance of football sign and falciform ligament sign.
Continuous diaphragm sign noted.
Air outlined both kidneys is in keeping with pneumoretroperitonuem.
Streaks of gas at the right lower quadrant, suspicious of subcutaneous emphysema.
CT:
Extensive pneumoperitoneum with falciform ligament sign.
A moderate amount of bilateral pneumoretroperitoneum.
Free gas is also in the subcutaneous fat of the right lower abdomen, right scrotum, retroperitoneum, mediastinum, chest wall and pericardium.
No rectal contrast extravasation from the lower colon to suggest a direct CT sign of large perforation.