Perforated duodenal ulcer with peritonitis

Case contributed by Ammar Haouimi

Presentation

Severe abdominal pain with generalized abdominal tenderness.

Patient Data

Age: 40 years
Gender: Male

Focal mural defect of the anterior wall of the duodenal bulb with adjacent extraluminal air bubbles as well as in the gastrohepatic ligament and under the left hemidiaphragm. Intraperitoneal effusion, extensive fat stranding with moderate thickening and enhancement of the peritoneal reflections. Reactive thickening with enhancement of the small bowel mainly the ileal loops. 

Dysmorphic liver (history of right hepatectomy for hydatid cysts) with partially calcified hydrated cyst adherent to the right hemidiaphragm.

Annotated image

Annotated images: the green arrows indicate the site of duodenal perforation.

Case Discussion

CT features of perforated duodenal ulcer with secondary peritonitis that was confirmed at surgery.

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