Department of Emergency Medicine

UMEM Educational Pearls

Title: What's the Diagnosis? Case by Dr. Mak Moayedi

Category: Visual Diagnosis

Posted: 11/23/2015 by Haney Mallemat, MD (Updated: 12/5/2015)
Click here to contact Haney Mallemat, MD

Question

An elderly patient presents with a history of weight loss and chronic constipation. The abdominal Xray is shown below. What's the diagnosis?

This one is tricky so here's a hint: why is the right kidney and psoas muscle so well defined?

 

Answer

  • Massive retroperitoneal and peritoneal free-air from ascending colon rupture
  • Colon cancer was eventually diagnosed in the operating room.
  • Notice that the kidney and psoas muscle outlined by the free-air below.

References

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