Perforated gastric ulcer
One day history of sudden onset of epigastric pain, nausea and vomiting. Taking regular ibuprofen for two weeks following a dental procedure.
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Large volume pneumoperitoneum.
The majority of the free gas is located in the upper abdomen. Mural defect on the lesser curvature of the stomach with thickening proximally. Moderate volume of intraperitoneal free fluid with mural thickening in the proximal ileum and distal jejunum.
Normal appearance of the liver, gallbladder, pancreas, spleen and large bowel. Distended urinary bladder.
This case illustrates a pneumoperitoneum from perforated gastric ulcer.
The patient underwent urgent laparoscopic omental patch repair. Intra-operatively, a pre-pyloric perforated ulcer approximately 2 mm in size was discovered. No features of neoplasm. Purulent contamination was reported in the right upper quadrant and pelvis.