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Duodenal perforation

Case contributed by Hidayatullah Hamidi
Diagnosis certain

Presentation

Acute severe epigastric area and vomiting for one week.

Patient Data

Age: 30 years
Gender: Male
ct

Irregular mural thickening and mucosal enhancement of the first and second parts of duodenum with peri-duodenal fat stranding and fluid.

Free fluid in the gall bladder fossa. A loculi of free air is noted near the second part of duodenum representing duodenal perforation. 

Case Discussion

Peptic ulcer disease can result perforation in ​up to 6% of cases. 

Perforation is usually a straightforward diagnosis, often with pneumoperitoneum visible. The site of perforation is sometimes visible as a region of discontinuity in the stomach or duodenal wall. 

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