Gastrointestinal ImagingPerforation, duodenal
A penetrating ulcer of the
duodenum may perforate directly into the peritoneal cavity, but if the perforation occurs on the posterior wall this usually becomes washed off. Peritonitis will result if the gastric contents leak into the peritoneal cavity, as will occur with the direct perforations.
The hallmark of diagnosis is pneumoperitoneum in a characteristic clinical setting this leads to surgical exploration. In elderly patients or when surgery for other reasons is contraindicated further evaluation with iodine contrast medium may reveal the site of the perforation.
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