Submitted by Dr TANG Kam Shing on 6 February 2009
ICU, Tuen Mun Hospital
M/ 70 admitted for COPD exacerbation requiring intubation. Several days after admission, increasing abdominal distension is noted.
Hemodynamically stable and afebrile. Ultrasound of abdomen at bedside was decided. The following image was noted at RLQ of abdomen. What do you think?
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Answer: The USG image showed a septum flowing in the ascites above the gut. This is likely due to peritonitis for some time. Urgent CT abdomen showed gross ascites and pneumoperitoneum. Emergency OT was done and showed PPU.