PMC4836307_01
Axial MDCT sections acquired from the upper abdomen. (A) Soft tissue window; (B) Pulmonary parenchymal window. Air in the intrahepatic bile ducts (A, gray arrow) (pneumobiliar, bilioenteric communication). Free air anterior to the liver and anterior peritoneal compartments in the left upper quadrant (A and B, black arrows) (pneumoperitoneum, consistent with gastrointestinal perforation). There was also free fluid in perihepatic and perisplenic space (A, stars). Pulmonary parenchymal window better delineates pneumoperitoneum.
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An abdominal MDCT scan without the administration of a contrast agent showed pneumobilia, free fluid in all peritoneal compartments, and free air consistent with intestinal perforation (Figure 1).
Axial (A), sagittal reformation (B), and coronal oblique reformation (C) images. There is a tubular foreign body density (arrow) in the free air and fluid levels (star).
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A tubular foreign body density with predominantly horizontal placement was observed in the pelvic region adjacent to the distal ileal loops in the supravesical area surrounded by free air and free fluid (Figures 2, 3).
In the bone window, the axial maximum intensity projection (MIP) image shows complete morphology of a tubular object in the peritoneum in the pelvic region (consistent with biliary stent).
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A tubular foreign body density with predominantly horizontal placement was observed in the pelvic region adjacent to the distal ileal loops in the supravesical area surrounded by free air and free fluid (Figures 2, 3).