Secondary duodenal diverticulum
Left upper quadrant pain.
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A saccular outpouching is seen in the medial wall of the first part of the duodenum.
Multiple hypodense nodules are seen in the liver.
Fatty enlargement of the right inguinal canal causing retraction of the anterior urinary bladder wall.
This patient had past history of ruptured peptic ulcer surgery, supporting the possibility a secondary duodenal diverticulum, which is commonly located in the first part of the duodenum and resulting from peptic ulcer disease.
Liver lesions are suggestive of metastasis, although no cancer diagnosis was known at the time.
The protrusion of the anterior urinary bladder wall could represent a hernia through the inguinal canal. A dynamic study could confirm this hypothesis.