Fig. 2

Perforated gastric carcinoma in a 73-year-old male patient presented with acute epigastric pain. a Non-contrast CT axial (lung window) image, showing a supramesocolic pneumoperitoneum (stars). b Post IV contrast CT axial image shows diffuse enhancing irregular thickening of gastric wall more evident at the fundal region (white arrowheads) and hydro-pneumoperitoneum (yellow arrows). c Post IV contrast CT axial image showing free air in ligamentum teres (blue arrowheads). d CT coronal post IV and oral contrast CT image, showing active contrast leakage on delayed phase (red arrows) through a focal defect in posterior gastric fundal wall (circle). e Histopathology showing infiltration of the deep muscle layer by sheets of highly pleomorphic tumor cells, confirming radiological findings of gastric carcinoma