Pneumothorax as a presentation of perforated duodenal ulcer

Abstract

A young man presented with a sudden onset of severe abdominal pain and vomiting. He also had shortness of breath with right-sided pleuritic chest pain. On examination he was found to have a rigid and diffusely tender abdomen. Auscultation of the chest revealed reduced air entry into the right lung. An erect chest X-ray confirmed the presence of pneumoperitoneum and a right-sided pneumothorax. He underwent placement of a right intercostal drain followed by urgent laparotomy. The intraoperative findings were consistent with a small duodenal perforation, which was managed by a simple omental patch closure. His postoperative course was uneventful. Pneumothorax is a rare complication of perforated duodenal ulcer and should be kept in mind while assessing patients who present with abdominal pain and dyspnoea. We have discussed various possibilities that should be considered in patients who present with a concomitant pneumothorax and pneumoperitoneum.

Forensic Considerations of Spontaneous Pneumothorax in Sudden Unexpected Natural Death

“…Many cases of SSP in pulmonary malignancies may be treatment-related, with tumor cavitation secondary to chemical or radiation therapies ((39), (40). Nonpulmonary etiologies for pneumothorax have also been reported, including pleural fistulas with esophageal, gastric or duodenal lumens, or hollow viscus perforations into the thoracic cavity (41–44).…”