Have you seen such a case before?

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A 64 years old non diadetic, nonhypertensive woman presents with 12 hours history of pain abdomen and distenton.She  is haemodynamically stable,but her abdomen is grossly distended and tender and silent.All her routine investigations are normal except for raised counts.Erect abdomen reveals grossly distended stomach but no free gas under Right dome.A CECT reveals free intraperitoneal air.The patient has obviously perforation of hollow viscus.What is  interesting about the case is the site ,size and pathology of perf. Any past experiences,intuitions,guesses.I will let you know what did i find in my next post.
R.M.Khattar Delhi.


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