Perforated duodenal ulcer
Presentation
Acute epigastric pain.
Patient Data
Age: 40 years
Gender: Male
From the case:
Perforated duodenal ulcer
CT
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Axial non-contrast
Small air-bubbles are noted within the peritoneal cavity mainly around the liver and gallbladder (see annotated images) with subhepatic and mesenteric fat stranding and minimal free fluid in the pelvic region.
A focal mural defect of the 2nd part of the duodenum is noted which may indicate the site of the duodenal perforation (see annotated images).
From the case:
Perforated duodenal ulcer
Annotated image
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Free air-bubbles
Annotated images:
- red arrows: extraluminal air-bubbles
- yellow arrows: site of perforation
Case Discussion
The clinical presentation and CT features are most consistent with a pneumoperitoneum secondary to a perforated duodenum which was confirmed at surgery as a perforated duodenal ulcer.
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