Postbulbar Ulcer With Retrocecal Abscess

Britt, L. G.; Wolf, Rodney Y.

doi:10.1001/archsurg.1966.01320190100023

Cited by 15 publications

(9 citation statements)

References 7 publications

(3 reference statements)

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“…Nevertheless, retroperitoneal abscesses due to duodenal perforation are rare. A total of 13 cases of retroperitoneal abscesses caused by duodenal perforation have been reported in nine articles [8][9][10][11][12][13][14][15][16] from 1966 to 2018. In most cases, the patients were over 40 years old, with an average age of 60.3; in this case, our patient was 28 years old, and thus relatively young.…”

Section: Discussionmentioning

confidence: 99%

“…Studies [8][9][10][11][12][13][14][15][16] show that surgery is the most common treatment for retroperitoneal abscesses caused by duodenal perforation. The mortality rate of patients with retroperitoneal abscesses by duodenal fistula was higher in the early stage because the retroperitoneal abscess was not found in time without a CT scan, and nursing and drainage technology were relatively poor.…”

Section: Discussionmentioning

confidence: 99%

“…In most cases, the patients were over 40 years old, with an average age of 60.3; in this case, our patient was 28 years old, and thus relatively young. The locations of duodenal perforations included the duodenal bulb (three cases) [ 8 , 14 , 16 ], the second segment of the duodenum (two cases) [ 13 , 14 ], the third segment of the duodenum (two cases) [ 9 , 15 ], and undetermined sites (six cases) [ 9 – 12 ]. In this case, the perforation was located in the anterior wall of the duodenal bulb, so the abscess was near the head of the pancreas.…”

Section: Discussionmentioning

confidence: 99%

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Imaging findings and clinical features of atypical retroperitoneal abscess caused by duodenal perforation: a case report and review of the literature

Mao

Jia

et al. 2020

J Med Case Reports

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Introduction: A retroperitoneal abscess caused by duodenal perforation is a relatively rare disease clinically. We report the case of a patient with a local high-density shadow at the head of the retroperitoneal pancreas. Case presentation: A 28-year-old Chinese man presented with fever and abdominal pain after overeating and heavy drinking. On physical examination, he had mild tenderness in his upper abdomen. Laboratory examination results showed a white blood cell count of 24.06 10 9 /L and a neutrophil absolute value of 18.81 10 9 /L, and a computed tomography scan showed an irregular soft tissue mass with uneven enhancement of the cystic wall in the retroperitoneal space. Gastroscopy showed that there was a fistula in the anterior wall of the duodenal bulb. Endoscopic anastomosis clip system (over-the-scope clip) of the duodenal fistula was performed successfully. After the operation, nasal feeding was provided with a nutrition tube, and empiric anti-infection, acid-inhibiting, and stomach-protecting treatments were administered. Our patient's body temperature gradually returned to normal, and his abdominal pain decreased. Conclusions: A retroperitoneal abscess caused by duodenal perforation can be diagnosed by clinical symptoms and abdominal computed tomography imaging. The choice of treatment should be based on accurate and timely clinical and imaging data.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Imaging findings and clinical features of atypical retroperitoneal abscess caused by duodenal perforation: a case report and review of the literature

Mao

Jia

et al. 2020

J Med Case Reports

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“…(12,(16)(17)(18)(19). The resulting inflammatory collection or abscess can distract the surgeon from the true perforation site.…”

Section: Discussionmentioning

confidence: 99%

An Unusual Localization Of Spontaneous Gastric Perforation: A Case Report

Demirel¹,

Karadayı²,

Serel³

et al. 2011

Ankara Üniversitesi Tıp Fakültesi Mecmuası

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75 yașında erkek hasta, sol frontal bölgesinde yer alan bir kitle nedeniyle kliniğimize bașvurdu. Yapılan insizyonel biyopsi sonucu saçlı deriye ait yassı hücreli kanser olarak değerlendirildi. Tümör geniș olarak eksize edilip, sol radial ön kol flebi ile rekonstrükte edildi. Operasyondan bir gün sonra lokalize edilemeyen epigastrik ağrı ve kontrol edilemeyen hıçkırma șikayetleri bașladı. Düz postero-anterior abdominal grafi ve bilgisayarlı tomografi görüntülerinde diaframın altında oldukça fazla miktarda serbest hava tespit edildi. Gastrointestinal perforasyon ön tanısı ile laporotomi yapıldı. Gastrik fundusun posterior duvarında bir perforasyon saptandı ve onarıldı. Erken postoperatif dönemde problemi olmayan hasta 10. günde myokardial enfarktüse bağlı olarak ex oldu. Bu hastada saptanan ve olgu sunumumuzda incelenen posterior gastrik duvardaki spontan perforasyon nadir görülen bir durumdur.Anahtar Sözcükler: Spontan gastrik perforasyon, serbest flep komplikasyonu, stress ülseri A 75 year-old male patient was admitted to Plastic Surgery Department complained a painless mass on his left frontal skin area. Histopathological examination was diagnosed the squamose cell carcinoma of the scalp. The tumor was excised widely and reconstructed with a left Chinese free flap. An unlocalised epigastric pain and uncontrolled hiccups was started on the first day after the operation. A plain abdominal roentgenogram and computed tomography demonstrated a large amount free air under the diaphragm. A laparotomy was performed under the diagnosis of gastrointestinal perforation, a perforation of the posterior wall of the gastric fundus was found. The patient died due to myocardial infarct on postoperative ten days. Spontaneous gastric perforation is very rare condition.

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“…According to current estimates, post-bulbar duodenal ulcers (PBDU) account for 5%-10% of all duodenal ulcers[ 1 ]. Most of these ulcers develop in the second part of the duodenum, with the majority occurring on the posteromedial wall of the duodenum[ 2 ]. The overall incidence of duodenal ulcers is 9.33%[ 3 ].…”

Section: Introductionmentioning

confidence: 99%

Post-bulbar duodenal ulcer with anterior perforation with kissing ulcer and duodenocaval fistula: A case report and review of literature

Alzerwi¹

2022

WJCC

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BACKGROUND A post-bulbar duodenal ulcer (PBDU) is an ulcer in the duodenum that is distal to the duodenal bulb. PBDU may coexist with a synchronous posterior ulcer in rare occurrences, resulting in a kissing ulcer (KU). Duodenocaval fistula (DCF) is another uncommon but potentially fatal complication related to PBDU. There is limited knowledge of the scenarios in which PBDU is complicated by KU and DCF simultaneously. CASE SUMMARY A 22-year-old man was admitted to the emergency department with abdominal pain, stiffness, and vomiting. The X-ray showed pneumoperitoneum, suggesting a perforated viscus. Laparotomy revealed a KU with anterior perforation and a DCF. After Kocherization, venorrahphy was used to control caval bleeding. Due to the critical condition of the patient, only primary duodenorrahphy with gastrojejunostomy was performed as a damage control strategy. However, later, the patient developed obstructive jaundice and leakage, and two additional jejunal perforations were detected. Due to the poor condition of the duodenum and the involvement of the ampulla in the posterior ulcer, neither primary repair nor pancreatic-free duodenectomy and ampulloplasty/ampullary reimplantation were considered viable; therefore, an emergency pancreaticoduodenectomy was performed, along with resection and anastomosis of the two jejunal perforations. The patient had a smooth recovery after surgery and was discharged after 27 d. CONCLUSION The timely diagnosis of PBDU and radical surgery can aid in the smooth recovery of patients, even in the most complex cases.

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Postbulbar Ulcer With Retrocecal Abscess

Cited by 15 publications

References 7 publications

Imaging findings and clinical features of atypical retroperitoneal abscess caused by duodenal perforation: a case report and review of the literature

Imaging findings and clinical features of atypical retroperitoneal abscess caused by duodenal perforation: a case report and review of the literature

An Unusual Localization Of Spontaneous Gastric Perforation: A Case Report

Post-bulbar duodenal ulcer with anterior perforation with kissing ulcer and duodenocaval fistula: A case report and review of literature

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