Duodenal perforation

Case contributed by Bálint Botz


Diffuse, sharp abdominal pain. Perforation?

Patient Data

Age: 70 years
Gender: Male

Left lateral decubitus AXR


An about 25 cm long, 1-2 cm thick crescent of free gas is visible along the right hemidaphragm and abdominal wall. The substantial and dependent pneumoperitoneum points towards a proximal bowel perforation. 

Case Discussion

During subsequent laparotomy an about 15 mm ulcerous perforation was found in the proximal duodenum 30 mm distal to the pylorus. 

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