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Perforated duodenal ulcer
PERFORATED DUODENAL ULCER
A 30-year-old man, previously in good health, presented with 1 week of epigastric abdominal pain of progressively increasing severity. Epigastric tenderness was noted on initial examination in the emergency department, but the abdomen was not rigid. Initial standard laboratory tests were unremarkable and a plain radiograph of the abdomen did not demonstrate any abnormality, including free air. At EGD, an acute ulcer was found on the anterior aspect of the duodenal bulb (A). Bubbles of air could be seen to issue from a small hole in the ulcer base (B). An anterior duodenal wall perforation was found at laparotomy, and a duodenorrhaphy was performed.
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GASTROINTESTINAL ENDOSCOPY
The postoperative recovery was uneventful, and the patient was discharged 1 week later. Cheng-Kuan Lin, MD Tzong-Hsi Lee, MD Department of Internal Medicine Heng-Fu Lin, MD Department of Surgery Chaw-Fung Jiang, MD Department of Internal Medicine Far Eastern Memorial Hospital Panchiao, Taiwan
PII: S0016-5107(04)01538-X
VOLUME 60, NO. 2, 2004
A 30-year-old man, previously in good health, presented with 1 week of epigastric abdominal pain of progressively increasing severity. Epigastric tenderness was noted on initial examination in the emergency department, but the abdomen was not rigid. Initial standard laboratory tests were unremarkable and a plain radiograph of the abdomen did not demonstrate any abnormality, including free air. At EGD, an acute ulcer was found on the anterior aspect of the duodenal bulb (A). Bubbles of air could be seen to issue from a small hole in the ulcer base (B). An anterior duodenal wall perforation was found at laparotomy, and a duodenorrhaphy was performed.
266
GASTROINTESTINAL ENDOSCOPY
The postoperative recovery was uneventful, and the patient was discharged 1 week later. Cheng-Kuan Lin, MD Tzong-Hsi Lee, MD Department of Internal Medicine Heng-Fu Lin, MD Department of Surgery Chaw-Fung Jiang, MD Department of Internal Medicine Far Eastern Memorial Hospital Panchiao, Taiwan
PII: S0016-5107(04)01538-X
VOLUME 60, NO. 2, 2004