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60 Y/O female with acute abdominal pain

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Comment by saeed rad on July 1, 2011 at 9:33am
What was is really dear Dr Niknejad?
Comment by M.T Niknejad on July 1, 2011 at 2:33am
Great , Thanks for comment my dear prof ...
Comment by saeed rad on July 1, 2011 at 1:28am

Thanks Dr Niknejad for the case. There are pneumoperitoneum, pneumoretroperitoneum, gastric pneumatosis and necrotic changes of the left lobe of the liver and pancreas, what i think it could be:

Vascular compromise in a brach to all of these, like gastric coronary vein, with congenital relation to the the left lobe of the liver, and pancreas.

Perforation of the posterior wall of the cardia which is the only retroperitoneal element in upper GI.

What else i don't know. But the vascular compromise, according to the age of the patient and acute abdomen will be my first choice.

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