case_images: PMC11670774_01
case_images: X-ray showing free air under both hemi-diaphragms, indicative of gastrointestinal perforation.
case_images: rjae800f1.jpg
case_images: PMC11670774_01_rjae800f1.jpg
case_images: f1
case_images: Plain abdominal X-rays revealed free gas under both hemi-diaphragms (Fig. 1).
case_images: Intraoperative photograph demonstrating triple gastric perforations (yellow, blue, and white arrows indicate the locations of the perforations).
case_images: rjae800f2.jpg
case_images: PMC11670774_01_rjae800f2.jpg
case_images: f2
case_images: Through intraoperative laparotomic exploration, surgeons discovered three distinct perforations: two perforations in the first part of duodenum with sizes of 0.5 and 1.5 cm, respectively, and another 1 cm perforation in the prepyloric region (Fig. 2).
case_images: Postoperative barium gastrography revealing good flow at the gastrojejunal anastomosis.
case_images: rjae800f3.jpg
case_images: PMC11670774_01_rjae800f3.jpg
case_images: f3
case_images: Postoperative barium gastrography 1 month later confirmed normal flow at the gastrojejunal anastomosis (Fig. 3).