Peptic ulcer with early localised perforation
Severe epigastric pain.
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There is oedematous thickening of the wall of the gastric antrum, pylorus and first part of the duodenum with mild surrounding fat stranding. The mucosa can be seen to enhance. There is one small focus of gas in the pyloric region which is outside the lumen but still contained by the oedematous wall. No free gas. Left paraumbilical hernia containing intra-abdominal fat which is mildly stranded. The hernia has a relatively small neck for the size of the herniated fat. Clinical assessment for reducibility and focal tenderness recommended.
Peptic ulcer in the pyloric region with early localised/contained perforation.