Authors: Ivan Kisyov, Stephen E McCabe/ Editor: Steve Corry-Bass / Reviewer: Stephen E McCabe, Ivan Kisyov / Codes: GP1, GP9, SLO1, SuP7 / Published: 25/11/2022 / Reviewed: 17/01/2026
A 24-year-old patient has presented with vomiting, abdominal pain, constipation and neck swelling.
He sustained multiple stab wounds to his chest and abdomen last month, requiring surgical repair. This was followed by an uneventful recovery.
Three days ago he started to develop abdominal pain. This has worsened and is now constant, suprapubic / Right Iliac Fossa, 8/10, sharp in nature and associated with vomiting.
Two days ago he started to notice some swelling in his neck, which has gradually become more painful.
He last opened his bowels 2 days ago and has passed flatus this morning.
He feels otherwise well and reports no symptoms on systems review. He is currently taking co-codamol for his post operative pain.
His chest X-ray is shown.
7 responses
Very nice case
quite interesting, this can easily be missed.
Very interesting and learning case. Thanks
History taking is very important in such cases or else CXR findings can be missed.
interested case . liked it
Interesting case. It can usually be missed especially in this CXR where findings are quite subtle apart from the obvious surgical emphysema. Well done, nicely presented case!
Nice case. Seen this once before. More likely to recognise in future now I have done this teaching.