Fig. 5

A 45-year-old man presented with suprapubic pain and dysuria. Abdominal examination showed guarding and tenderness in the suprapubic region. POCUS using a high-frequency linear probe (a) showed thickened inflamed small bowel (arrowheads) having gas within it (white dashed arrow). The significant free intra-peritoneal air was seen as an “enhanced peritoneal stripe sign” which is the hyperechoic white line located just under the abdominal fascia (yellow arrow). The reverberation lines (white arrows) represent the repetition of the reflective waves. Rectal examination detected a large self-inflicted rectal tear. Laparotomy confirmed the findings (b)