Non-Travmatik Tam Kat Duodenum Perforasyonu: Vaka Sunumu

Year 2024, Volume: 2 Issue: 2, 71 - 74, 30.06.2024

Ahmet Başak , Turgut Anuk

https://doi.org/10.61845/agrimedical.1409939

Abstract

Non-Traumatic Full-Thickness Duodenal Perforation: a Case Report

Abstract

Duodenal perforation is a life-threatening condition with high mortality and morbidity. In this study, we aim to present a case of spontaneous duodenal perforation that was detected and treated. The 66-year-old male patient, who applied to the emergency clinic with complaints of malaise, fever, weakness and shortness of breath, had no additional disease other than Chronic obstructive pulmonary disease and dementia. Pneumonia was diagnosed based on physical examination and imaging findings, and he was admitted to the pulmonology clinic and treated. During follow-ups, the patient developed sepsis and an acute abdominal pain. An emergency laparotomy revealed a non-traumatic spontaneous duodenal perforation, which caused near ruptured duodenum. The perforated duodenum part was resected and gastrojejunostomy was performed. The rupture of the duodenum and large duodenal perforation can occur in association with iatrogenic or trauma-related causes. In the patient who had no history of trauma, the most likely cause of perforation was thought to be peptic ulcer. It was thought that possible peptic ulcer perforation expanded with necrosis over time. In cases without a history of trauma, the possibility of large duodenal perforation or rupture should not be ruled out, and if there is suspicion of spontaneous duodenal perforation, laparotomy should not be avoided.

Keywords

Intestinal perforation, Pneumonia, Acute Abdomen

References

• Søreide K, Thorsen K, Harrison EM, et al. “Perforated peptic ulcer”. The Lancet. Lancet Publishing Group; 2015; 386: 1288–98.
• Gupta S, Kaushik R, Sharma R, et al “The management of large perforations of duodenal ulcers.” BMC Surgery. BioMed Central Ltd.; 2005;5
• Dodiyi-Manuel A *, Pn W, Vc E. “Presentation and managent of perforated peptic ulcer disease in a tertiary centre in South Nigeria.” J West Afr Coll Surg. 2015;5:36–48.
• Sasegbon A. “When is pneumonia not pneumonia?” BMJ Case Rep [Internet]. 2015;
• Celik A, Altinli E, Koksal N, et al. “Management of isolated duodenal rupture due to blunt abdominal trauma: Case series and literature review.” European Journal of Trauma and Emergency Surgery. 2010;36(6):573–8.
• Anuk Turgut. “Colon perforation due to inflammatory bowel disease: Delayed diagnosis and rare complication.” Ağrı Med J.; 2023;1: 15–7.
• Cao F, Li J, Li A, et al. “Nonoperative management for perforated peptic ulcer: Who can benefit?” Asian J Surg. 2014;37(3):148–53.
• Ansari D, Torén W, Lindberg S, et al. “Diagnosis and management of duodenal perforations: a narrative review.” Scandinavian Journal of Gastroenterology. Taylor and Francis Ltd; 2019;54: 939–44.
• Lal P, Vindal A, Hadke NS. “Controlled tube duodenostomy in the management of giant duodenal ulcer perforation-a new technique for a surgically challenging condition.” Am J Surg. 2009;198(3):319–23.