CTICasesPneumoperitoneum from Perforated Gastric Stress Ulcer
▶ Watch on YouTube — age-restricted, cannot embed here
Imaging findings
In a critically ill patient with an Impella device, a rapidly developing large volume of pneumoperitoneum was observed on a supine portable chest radiograph. Surgical exploration confirmed a large ulcer in the greater curve of the stomach, with murky brownish fluid and gastric contents, indicating perforation. No pneumatosis was noted.
Key takeaways
Pneumoperitoneum is a critical and urgent finding in ICU patients, even when subtle on supine portable chest radiographs. Critically ill patients, particularly those with low output states or post-myocardial infarction and supported by devices like Impella, are at high risk for developing and perforating stress ulcers. Early recognition of free air on radiographs is paramount for prompt surgical intervention.
AI-assisted summary — may contain errors. Verify against the source video. Learn more
More from this webinar
- Renal Cell Carcinoma with Lymphangitic CarcinomatosisNeoplastic
- Miliary TuberculosisInfection
- Presumed Kawasaki Disease with Coronary AneurysmsVascular
- Calcified Mediastinal/Pericardial Mass (Old Hematoma)Inflammatory
- Massive Mediastinal LiposarcomaNeoplastic
- Interstitial Lung Edema with Lymphatic PearlsVascular
- Mucus in Airways Simulating Parenchymal Nodules (MIPS Pitfall)Artifact
- Extralobar Sequestration with Phrenic Nerve InvolvementCongenital
See all cases from July 10, 2015 →