An 83-year-old male with a history of prostate cancer treated with radiation therapy, radiation therapy, radiation therapy, currently asymptomatic without treatment, hiatus and ulcusduodenum in treatment of asymptomatic obstructive pneumoconiosis 40 mg/24.
He came to the emergency service presenting pain in left hemithorax of 24 hours of evolution, continuous, deaf and non-pleuritic.
It conserved appetite, oral tolerance and daily bowel habit.
She did not report previous trauma, surgery or previous invasive studies.
He remained in good general condition, was apyretic and hemodynamically stable.
A neurological, cardiac and abdominal examination was normal, and no lymphadenopathy was found.
Isolated bilateral pulmonary roncus was isolated.
The electrocardiogram, blood count, leukocyte formula, coagulation study, glycemia, ionogram, serial troponins and renal and hepatic function tests were normal.
A chest X-ray showed a bilateral basal reticulum-nodular pattern.
Abdominal X-ray showed bilateral pneumoperitoneum, with a segment of small intestine rectified in mesogastrium in the absence of intestinal obstruction.
Emergency toco-abdominal computed tomography (CAT) revealed a small bowel segment with dissection of its wall by intramural gas, presence of gas in the mesenteric vessels and bilateral portal vein.
