Perforated gastric ulcer with abscess formation

Case contributed by Ammar Haouimi
Diagnosis almost certain

Presentation

Known case gastric disease, presented with an acute abdomen with fever.

Patient Data

Age: 45 years
Gender: Male

Regular circumferential thickening of the antropyloric region, with preservation of the mucous layer. A focal prepyloric wall defect is noted, containing small air bubbles. This focal perforation appears in continuity with a large subhepatic collection with air-fluid level, extending to the segment IV of the liver, surrounded by a low attenuation outer ring (edema of the adjacent liver parenchyma). Secondary thickening of the gallbladder wall.

Right cortical renal cyst.

 

Case Discussion

A case of a perforated peptic ulcer of the prepyloric region (Type III according to the modified Johnson classification of peptic ulcers) with abscess formation.

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