Figure 4a. Ruptured teratoma in a 51-year-old woman with a palpable periumbilical mass. (a) Axial contrast-enhanced CT scan shows a floating fat droplet (arrowhead) with a fat-fluid level in the perihepatic space and ascites in the peritoneal space. The hazy omental infiltration is suggestive of chronic granulomatous peritonitis. (b) Axial contrast-enhanced CT scan of the pelvis shows an ovarian teratoma (*) with fat attenuation and foci of calcification. (Case courtesy of Y. W. Kim, MD, Pusan Baik Hospital, Busan, Korea.) a pneumoperitoneum is suspected because of the cost and radiation burden of the procedure.