A 48-year-old man was admitted to our emergency department 12 hours after a bicycle accident with abdominal pain, nausea, and vomiting. He described abdominal trauma caused by the bicycle handlebar. The patient reported undergoing an appendectomy at age 23 years and having ulcerative colitis since he was aged 30 years. He had received treatment (mesalazine and corticosteroids) for inflammatory bowel disease that had been discontinued.

Physical examination revealed paraumbilical ecchymosis (Figure 1A), general abdominal tenderness, and distension. Body temperature, blood pressure, and heart and respiratory rates were normal. Laboratory test findings did not show abnormalities except for the leukocyte count (12 300 cells/μL [to convert to ×10⁹/L, multiply by 0.001]); hemoglobin and hematocrit levels were within the reference ranges. An abdominal computed tomographic (CT) scan, performed immediately, revealed a pneumoperitoneum and free fluid in the lower quadrants of the abdomen (Figure 1B).

自行车事故发生12小时后，一名48岁的男子因腹痛，恶心和呕吐而入我们的急诊室。他描述了自行车车把造成的腹部创伤。该患者报告说他在23岁时接受了阑尾切除术，并且从30岁开始就患有溃疡性结肠炎。他已经接受了已停止治疗的炎症性肠病的治疗（美沙拉嗪和皮质类固醇）。

体格检查发现脐旁瘀斑（图1A），全身腹部压痛和腹胀。体温，血压，心脏和呼吸频率均正常。实验室检查结果除白细胞计数（12 300个细胞/μL[转换为×10 ⁹ / L，乘以0.001]）外未显示异常。血红蛋白和血细胞比容水平在参考范围内。立即进行的腹部计算机断层扫描（CT）扫描显示，气腹和腹部下腹有游离液体（图1B）。