Acute severe epigastric area and vomiting for one week.
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Irregular mural thickening and mucosal enhancement of the first and second parts of duodenum with peri-duodenal fat stranding and fluid.
Free fluid in the gall bladder fossa. A loculi of free air is noted near the second part of duodenum representing duodenal perforation.
Peptic ulcer disease can result perforation in up to 6% of cases.
Perforation is usually a straightforward diagnosis, often with pneumoperitoneum visible. The site of perforation is sometimes visible as a region of discontinuity in the stomach or duodenal wall.