PMC5752217_01
CT scan showing pneumopericardium, pneumomediastinum and extensive pneumoperitoneum.
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Computed tomography (CT) chest/abdomen/pelvis showed pneumopericardium, pneumomediastinum and extensive pneumoperitoneum resulting in a mass effect upon the abdominal and pelvic organs (Fig. 1, Fig. 2).
Contrast esophagram without extravasation.
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The study was without active extravasation and esophageal perforation was much less on our differential of free intraperitoneal air etiology (Fig. 3).
One of the two gastric perforations (about three cm each) on the lesser curvature of the stomach near the GE junction.
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Upon exploration of the abdomen, patient was found to have two large (about three centimeter each) gastric perforations on the lesser curvature of the stomach near the gastroesophageal junction without other injuries (Fig. 4).