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Images in emergency medicine
Coffee ground vomitus in 84-year-old male
  1. Mingtse Tsai1,
  2. Jiannming Wu2,
  3. Chanping Su1
  1. 1Department of Emergency Medicine, Far Eastern Memorial Hospital, New Taipei City, Taiwan
  2. 2Department of Surgery, Far Eastern Memorial Hospital, New Taipei City, Taiwan
  1. Correspondence to Dr Mingtse Tsai, Department of Emergency Medicine, Far Eastern Memorial Hospital, No. 21, Sec. 2, Nanya South Road, Banciao District, New Taipei City 22060, Taiwan; kakaitsai{at}gmail.com

https://doi.org/10.1136/emermed-2013-203508

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    An 84-year-old man presented to our emergency department because of coffee ground vomitus over several days. Physical examination revealed right scrotal swelling with crepitus (figure 1). kidney, ureter, bladder (KUB) radiography (figure 2) was arranged; however, 2 h later, his condition deteriorated. CT revealed extensive pneumoretroperitoneum extending from the posterior surface of the liver down to the right inguinal canal (figure 3). Emergent surgery …

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    Footnotes

    • Contributors CS was the primary physician who provided care to the patient in the emergency room. JW was the surgeon who found the ulcer was the real cause of shock and retroperitoneal abscess. MT was responsible for data collection and article submission. MT, 12 December 2013.

    • Competing interests None.

    • Patient consent Obtained.

    • Provenance and peer review Not commissioned; internally peer reviewed.