Perforated duodenal ulcer

Case contributed by Dr Craig Hacking


Epigastric pain.

Patient Data

Age: 40 years
Gender: Female

A 2 cm structure containing faecal-like material and gas is seen arising from D3, however no oral contrast enters it. No bowel wall contains it and it displaces the common bile duct and pancreatic head anteriorly. Small volume of free fluid posterior to the diverticulum, tracking into the right anterior pararenal space. No intra- or extra-hepatic bile duct dilatation. No peripancreatic fat stranding or fluid around the body or tail. No pneumoperitoneum.

The remainder of the intra-abdominal and pelvic organs are unremarkable. Tampon in situ. Rectus abdominis diastasis. Bibasal atelectasis.


Appearances are consistent with a retroperitoneal perforation, likely secondary to perforated duodenal ulcer.

Case Discussion

Surgery confirmed the perforated ulcer which was oversewn.

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Case information

rID: 41268
Published: 25th Nov 2015
Last edited: 14th Sep 2017
Inclusion in quiz mode: Included

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