Three-dimensional computed tomography reconstruction diagnosed digestive tract perforation and acute peritonitis caused by Monopterus albus: A case report

Figure 1 Imaging and laparoscopic exploration. A: Computed tomography (CT) with multi-plane reconstruction revealed scattered exudation, peritoneal thickening (orange arrow), peritoneal effusion (purple arrow), and free gas (blue arrow) in the abdominal cavity, suggesting gastrointestinal perforation complicated with acute peritonitis; B: Curved planar reconstruction (CPR) of CT images showed an abdominal Monopterus albus that has bitten the mesentery, indicating a foreign body outside the intestinal cavity; C: CPR of CT images revealed rough and raised outer margin of the wall of the mid-rectum (white arrow), as well as exudation and free gas in the surrounding mesentery (blue arrow), indicating a perforation in the mid-rectum; D: Volume reconstruction revealed clear and complete Monopterus albus bone morphology in the abdominal and pelvic cavities; E: Laparoscopic exploration revealed a large perforation in the mid-rectum, with a diameter approximating 1.5 cm; F: Laparoscopic exploration showed the Monopterus albus has perforated the mesentery of the small intestine; G: During the operation, the dead Monopterus albus was taken out, with a length of about 40 cm.