case_images: PMC8091627_01
case_images: Supine abdominal X-ray with high suspicion of free air under the diaphragm
case_images: qmj-2021-014-g001.jpg
case_images: PMC8091627_01_qmj-2021-014-g001.jpg
case_images: fig1
case_images: The patient could not tolerate standing for an upright chest X-ray, and a supine abdominal X-ray showed a suspicion of free air (Figure 1).
case_images: Intraoperative image of perforation controlled with bowel clamp
case_images: qmj-2021-014-g002.jpg
case_images: PMC8091627_01_qmj-2021-014-g002.jpg
case_images: fig2
case_images: ASA IV and taken to the operating room at high risk of death and perioperative complications. An emergency midline laparotomy was performed, which revealed fecal matter all over the abdomen and a 2-cm free perforation of the sigmoid colon in addition to multiple diverticula in which some of them were included in the tear (Figure 2).