Contained duodenal ulcer perforation

Case contributed by Dr Chris O'Donnell

Presentation

Acute onset of abdominal pain radiating to the back

Patient Data

Age: 55
Gender: Male
Modality: CT

Markedly thick-walled (oedematous) distal stomach with a gas and fluid-filled cavity sitting behind the duodenal first part communuicating via a defect in the wall with the lumen.

Case Discussion

Differential diagnosis is duodenal diverticulum - in this case refuted by the presence of gross adjacent gastric wall oedema (inflammation) and the mural defect location, i.e. first part rather than the more typical second for diverticulum. Contained duodenal peptic perforations are more common posteriorly (as compared with pneumoperitoneum in anterior perforation) and typically present with pain radiating to the back (in this case prompting a CT angiogram for clinically supected aortic dissection).

PlayAdd to Share

Case Information

rID: 30070
Case created: 16th Jul 2014
Last edited: 20th Dec 2015
Inclusion in quiz mode: Included

Updating… Please wait.
Loadinganimation

Alert accept

Error Unable to process the form. Check for errors and try again.

Alert accept Thank you for updating your details.