Distal ileal perforation ( August week3)

Mild to moderate amount of free fluid in abdomen and pelvis (10 to 20 HU) associated with pneumoperitoneum in anterior upper abdomen, subphrenic spaces, perihepatic spaces along falciform ligament – related to *hollow viscus perforation*.

A large encysted fluid collection in right lower quadrant demonstrating air fluid levels

Short segment mild asymmetrical mural thickening of distal ileum is noted, in the right lower quadrant, demonstrating a small defect in the anterior wall of distal ileum apparently communicating with the above-mentioned right lower quadrant intraperitoneal collection – *suggestive of most probable site of perforation at the *distal ileum*.

Mild thickening of proximal duodenum at D1, D2 segment of ? clinical significance.

Mild splenomegaly