
Fig. 1.
Tangencial X-ray of abdominal showing free gas in abdominal cavity.

Fig. 2.
Thoraco-abdominal CT showing SE and moderate pneumomediastinum (axial - A, coronal - C) and a large pneumoperitoneum (axial - B, sagital - D).

Fig. 3.
Emergency percutaneous needle decompression. The catheter was connected to an underwater seal drainage system.