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Football sign

Case contributed by Yusra Sheikh
Diagnosis certain

Presentation

Patient presented to ED with severe abdomen. On examination the abdomen was tense

Patient Data

Age: 40 years old
Gender: Female
x-ray

There is a massive ovoid lucency over the entire abdomen, consistent with massive pneumoperitoneum. No dilated bowel loops. A nasoenteric tube is in situ.

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