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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 …
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.