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  • There was a general loss of serosal detail in the abdomen.
  • There is a large pocket of free air noted in the cranial abdomen outlining the serosal margins of the stomach and cranial dorsal abdomen. On the VD view, this is outlining the falciform fat and ventral abdominal viscera creating a sharply marginated structure noted on midline at the thoracolumbar junction.
  • There are numerous small gas bubbles noted in the abdomen that are not contained within the small intestines. There are two well delineated mineral opacities in the right dorsal abdomen associated with the right ureter.
  • There is severe osteoarthrosis in both coxofemoral joints.
  • The radiographic changes are consistent with peritoneal effusion and pneumoperitoneum. This finding is most consistent with the gastrointestinal perforation and associated septic peritonitis.
  • Surgical exploration is indicated.
  • The ureteroliths present are incidental in this case.