Presentation
Fever, abdominal pain, and distension.
Patient Data
A large cavity containing air and contrast material is seen, which extends from the anterior pelvic cavity up to the right subphrenic space, leading to bulging of the right side of the abdomen. The cavity mimics the dilated colon and may be missed easily. A focus of anterior cecal wall defect is seen that contrast passes through it into the mentioned cavity. Few fistulous tracts between the cavity and the cecum are also visible.
The contrast within the bladder in the corticomedullary phase is the excreted contrast of a previous contrast-enhanced study.
The red arrow points to the cavity containing air and contrast. The blue arrow shows the sites of cecal wall perforation.
Case Discussion
The patient went to the operating room following initial resuscitation. A few foci of cecal perforation were found at surgery, and the cavity drained.
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