A 54-year-old male presented to the emergency department with complaints of “lower back pain, abdominal pain, and extreme abdominal distension for 24 h after falling from height”. Twenty-four hours before presenting to the emergency department, the patient fell from a height of approximately 3 meters causing lower back pain, and was treated in another hospital. An X-ray showed 12 thoracic vertebral compression fractures. After hospitalization, the patient experienced unbearable severe abdominal distension and abdominal pain and was transferred to our hospital for escalation of care. The patient had no relevant surgical or medical history. The patient had no relevant family medical history. Temperature 36 °C, blood pressure 85/60 mmHg, respiration rate 30 breaths per minute, heart rate 145 beats per minute, blurred consciousness, flat abdomen, abdominal rigidity, obvious abdominal tenderness with rebound, absent liver dullness, and absent bowel sounds. A complete blood analysis was performed with the following pertinent results: White blood cell count 4800/mm3; neutrophils 75.3%; hemoglobin 143 g/L; C-reactive protein 130 mg/L; Po2 54.5 mmHg; and Pco2 26 mmHg. Abdominal computed tomography (CT) showed pneumoperitoneum, ascites, and portal venous gas.