Emergency #22 – Long case

81-year-old male:

* Severe pain abdomen
* Tender abdomen
* Clinical ileus

What do you see?

Diagnosis

Mechanical ileus with caliber change in ileum. Distended stomach with air in the major curvature of the wall, with air bubble outside lumen, suspect for pneumatosis intestinalis. Extended air in left portal vein branches and in central portal vein (portal venous gas peripheral, gas in bile ducts central).

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What additional findings do you see?

1. Contained rupture AAA with slowly progressive lytic destruction and remodeling of lumbar spine
2. Gall stones

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