case_images: PMC11179459_01
case_images: A simple abdominal X-ray with a lateral view of the diaphragm was performed upon the patient's immediate admission to the hospital. The X-ray revealed a single large gas-fluid level approximately in the area of the stomach, without the presence of gas distribution in the rest of the abdomen. The lung bases were within normal limits, and there were no other remarkable findings, the arrow indicates the gas-fluid level.
case_images: 10.1177_2050313X241262141-fig1.jpg
case_images: PMC11179459_01_10.1177_2050313X241262141-fig1.jpg
case_images: fig1-2050313X241262141
case_images: A simple chest X-ray, obtained 2 h after the patient's admission, revealed large gas crescent signs of the lateral aspects of the diaphragm and outlined the anatomical configuration of the liver on the right side (pneumoperitoneum), with the gas-fluid level remaining in the epigastric area but with a smaller size as the arrows show. The remainder of the image was within normal limits (a). A simple abdominal and pelvic X-ray obtained several hours after the patient's admission showed the gas-fluid level, pneumoperitoneum, and the absence of gas distribution in the rest of the abdomen (b).
case_images: 10.1177_2050313X241262141-fig2.jpg
case_images: PMC11179459_01_10.1177_2050313X241262141-fig2.jpg
case_images: fig2-2050313X241262141
case_images: Both chest and abdominal X-rays were re-performed and revealed severe pneumoperitoneum which suspected viscus perforation as seen in Figure 2.
case_images: A large bulk spleen was seen in the exploratory laparotomy.
case_images: 10.1177_2050313X241262141-fig3.jpg
case_images: PMC11179459_01_10.1177_2050313X241262141-fig3.jpg
case_images: fig3-2050313X241262141
case_images: The Surgical Procedure: An exploratory laparotomy was performed with a midline incision and the doctors found a bulky and huge wandering spleen reaching the pelvis and the right iliac fossa, as seen in Figure 3.
case_images: PMC11179459_02