suggesting site of perforation at  anterolateral wall of D1 segment of duodenum.  

Small free fluid  in abdomen and pelvis  with marked pneumoperitoneum – suggestive of hollow viscus perforation.  

 Edematous/thickened proximal duodenum at D1 segment with evidence of a thin defect in the lateral wall with surrounding periduodenal fat stranding – suggesting site of perforation at  anterolateral wall of D1 segment of duodenum.  

 Dilated small and large bowel loops with multiple air fluid levels,  without evidence of obvious transition point – suggestive of Adynamic ileus.  

 Bulky appearing uterus with parametrial haziness with 4.4 x 2.0 cm right adnexal pelvic cyst