GOOD NEWS: We have fixed the DICOM uploading problem. New cases should work fine. More info radiopaedia.org/chat

Perforated duodenal ulcer

Case contributed by Ammar Haouimi
Diagnosis almost certain

Presentation

Acute epigastric pain.

Patient Data

Age: 40 years
Gender: Male
ct

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).

Annotated image

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.

How to use cases

You can use Radiopaedia cases in a variety of ways to help you learn and teach.

Creating your own cases is easy.

Updating… Please wait.

 Unable to process the form. Check for errors and try again.

 Thank you for updating your details.