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60 Y/O female with acute abdominal pain
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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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