c l i n i c a l f o l i o s : n a r r a t i v e





A D V E R T I S E M E N T

 

Pseudopneumoperitoneum: 1

A D V E R T I S E M E N T

   
 

A 31-year-old man presented with a few hour history of right lower quadrant abdominal pain following an all-you-can-eat meat meal in which the patient indulged. Abdominal film was read as showing free air in the peritoneal cavity.       

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Pseudopneumoperitoneum: 2

A D V E R T I S E M E N T

   
 

Upright chest X-ray exhibited the same finding. The patient had mild right lower quadrant tenderness with minimal guarding and no rebound. There was no guarding or rebound over the rest of the abdomen. On close questioning, the patient stated he had had upper abdominal pain a year prior to the present admission and tested positive for h. pylori. The symptoms disappeared and the patient the did not take the prescribed course of antibiotics.      

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Pseudopneumoperitoneum: 3

A D V E R T I S E M E N T

   

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The patient was taken to the operating room for laparoscopic exploration with a presumptive diagnosis of perforated viscus, stomach more likely than appendix. A Hasson umbilical port was placed. An NG tube was passed, but the stomach could not be decompressed because it was packed solid with meat.    

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This page was last modified on 8/27/2007.