Perforated duodenal ulcer

Case contributed by Dr Craig Hacking

Presentation

Epigastric pain.

Patient Data

Age: 40 years
Gender: Female
CT

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.

Conclusion

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
Case created: 24th Nov 2015
Last edited: 14th Sep 2017
Inclusion in quiz mode: Included

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