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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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