Duodenal perforation (D1)

Case contributed by Antoni Boscà
Diagnosis almost certain


4 hours epigastric pain, nausea, and vomiting.

Patient Data

Age: 60 years
Gender: Female

A small amount of extraluminal free gas representing pneumoperitoneum with a discontinuity in the anterior wall of the duodenum (D1). Mural thickening and mucosal enhancement of duodenum (D1, D2) with paraduodenal fat stranding and free fluid are also noted. Image findings consistent with duodenal perforation.

Case Discussion

Perforation is a surgical emergency. The patient underwent laparoscopic surgery which confirmed the presence of first part duodenal perforation consistent with CT findings.

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