A large non-enhancing uterine fibroid with heterogeneous texture and signal voids consistent with gas loculi. The uterine wall at the fundus of the uterus overlying the lesion is markedly thinned with focal disruptions. Large amount of ascites is noted with evident restricted diffusion demonstrating hyperintense DWI and low ADC signal suggestive of pus. Evidence of pneumoperitoneum is noted with air-fluid level as well as diffuse uniform thickening and enhancement of the peritoneal wall. Bilateral small amount of pleural effusion with mild bilateral basal atelectasis. Incidentally noted is a sliding para-oesophageal hiatus hernia.