Perforated duodenal ulcer presenting with a subphrenic abscess revealed by plain abdominal X-ray films and confirmed by multi-detector computed tomography: A case report (345 views)
J Med Case Rep (ISSN: 1752-1947, 1752-1947linking), 2013 Nov 11; 7: 257-257.
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Paper type: Abstract, Conference, Journal Article,
Impact factor: 0.895, 5-year impact factor: 1.273
Url: http://www.scopus.com/inward/record.url?eid=2-s2.0-84887153973&partnerID=40&md5=395c7240273320d0bc84be1983e3d1f1
Keywords: Abdominal Plain Film, Multi-Detector Computed Tomography, Peptic Ulcer Disease, Subphrenic Abscess, Imatinib, Meglumine Diatrizoate, Methylene Blue, Abdominal Radiography, Adult, Article, Case Report, Chronic Myeloid Leukemia, Contrast Enhancement, Duodenum Ulcer, Human, Laparotomy, Maintenance Therapy, Multidetector Computed Tomography, Priority Journal, Ulcer Perforation, X Ray Film,
Affiliations:
*** IBB - CNR ***
Department of Radiology, University Federico II, Via S. Pansini 5, 80131 Naples, Italy
Institute of Biostructures and Bioimaging, National Research Council (C.N.R.), Via Tommaso De Amicis 95, 80145 Naples, Italy
Department of Infectious Diseases, University Federico II, Via S. Pansini 5, 80131 Naples, Italy
Department of Emergency Surgery, AORN A. Cardarelli, Naples, Italy
References:
Not available.
J Med Case Rep (ISSN: 1752-1947, 1752-1947linking), 2013 Nov 11; 7: 257-257.
Export to BibTeX Export to EndNote
Paper type: Abstract, Conference, Journal Article,
Impact factor: 0.895, 5-year impact factor: 1.273
Url: http://www.scopus.com/inward/record.url?eid=2-s2.0-84887153973&partnerID=40&md5=395c7240273320d0bc84be1983e3d1f1
Keywords: Abdominal Plain Film, Multi-Detector Computed Tomography, Peptic Ulcer Disease, Subphrenic Abscess, Imatinib, Meglumine Diatrizoate, Methylene Blue, Abdominal Radiography, Adult, Article, Case Report, Chronic Myeloid Leukemia, Contrast Enhancement, Duodenum Ulcer, Human, Laparotomy, Maintenance Therapy, Multidetector Computed Tomography, Priority Journal, Ulcer Perforation, X Ray Film,
Affiliations:
*** IBB - CNR ***
Department of Radiology, University Federico II, Via S. Pansini 5, 80131 Naples, Italy
Institute of Biostructures and Bioimaging, National Research Council (C.N.R.), Via Tommaso De Amicis 95, 80145 Naples, Italy
Department of Infectious Diseases, University Federico II, Via S. Pansini 5, 80131 Naples, Italy
Department of Emergency Surgery, AORN A. Cardarelli, Naples, Italy
References:
Not available.
Perforated duodenal ulcer presenting with a subphrenic abscess revealed by plain abdominal X-ray films and confirmed by multi-detector computed tomography: A case report
Introduction. Peptic ulcer disease is still the major cause of gastrointestinal perforation despite major improvements in both diagnostic and therapeutic strategies. While the diagnosis of a perforated ulcer is straightforward in typical cases, its clinical onset may be subtle because of comorbidities and/or concurrent therapies. Case presentation. We report the case of a 53-year-old Caucasian man with a history of chronic myeloid leukemia on maintenance therapy (100mg/day) with imatinib who was found to have a subphrenic abscess resulting from a perforated duodenal ulcer that had been clinically overlooked. Our patient was febrile (38.5°C) with abdominal tenderness and hypoactive bowel sounds. On the abdominal plain X-ray films, a right subphrenic abscess could be seen. On contrast-enhanced multi-detector computed tomography, a huge air-fluid collection extending from the subphrenic to the subhepatic anterior space was observed. After oral administration of 500cm§ssup§ 3§esup§ of 3 percent diluted diatrizoate meglumine, an extraluminal leakage of the water-soluble iodinated contrast media could then be appreciated as a result of a perforated duodenal ulcer. During surgery, the abscess was drained and extensive adhesiolysis had to be performed to expose the duodenal bulb where the ulcer was first identified by methylene blue administration and then sutured. Conclusions: While subphrenic abscesses are well known complications of perforated gastric or duodenal ulcers, they have nowadays become rare thanks to advances in both diagnostic and therapeutic strategies for peptic ulcer disease. However, when peptic ulcer disease is not clinically suspected, the contribution of imaging may be substantial. © 2013 Camera et al.; licensee BioMed Central Ltd.
Introduction. Peptic ulcer disease is still the major cause of gastrointestinal perforation despite major improvements in both diagnostic and therapeutic strategies. While the diagnosis of a perforated ulcer is straightforward in typical cases, its clinical onset may be subtle because of comorbidities and/or concurrent therapies. Case presentation. We report the case of a 53-year-old Caucasian man with a history of chronic myeloid leukemia on maintenance therapy (100mg/day) with imatinib who was found to have a subphrenic abscess resulting from a perforated duodenal ulcer that had been clinically overlooked. Our patient was febrile (38.5°C) with abdominal tenderness and hypoactive bowel sounds. On the abdominal plain X-ray films, a right subphrenic abscess could be seen. On contrast-enhanced multi-detector computed tomography, a huge air-fluid collection extending from the subphrenic to the subhepatic anterior space was observed. After oral administration of 500cm§ssup§ 3§esup§ of 3 percent diluted diatrizoate meglumine, an extraluminal leakage of the water-soluble iodinated contrast media could then be appreciated as a result of a perforated duodenal ulcer. During surgery, the abscess was drained and extensive adhesiolysis had to be performed to expose the duodenal bulb where the ulcer was first identified by methylene blue administration and then sutured. Conclusions: While subphrenic abscesses are well known complications of perforated gastric or duodenal ulcers, they have nowadays become rare thanks to advances in both diagnostic and therapeutic strategies for peptic ulcer disease. However, when peptic ulcer disease is not clinically suspected, the contribution of imaging may be substantial. © 2013 Camera et al.; licensee BioMed Central Ltd.
Perforated duodenal ulcer presenting with a subphrenic abscess revealed by plain abdominal X-ray films and confirmed by multi-detector computed tomography: A case report
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Perforated duodenal ulcer presenting with a subphrenic abscess revealed by plain abdominal X-ray films and confirmed by multi-detector computed tomography: A case report
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* Contrast enhanced multi-detector CT and MR findings of a well-differentiated pancreatic vipoma (335 views)
World J Radiol (ISSN: 1949-8470, 1949-8470electronic, 1949-8470linking), 2014 Oct 28; 6(10): 840-845.
Impact Factor: 0.567
View Export to BibTeX Export to EndNote
Camera L, Sagnelli M, Guadagno P, Mainenti PP, Marra T, Scotto di Santolo M, Fei L, Salvatore M
* Colonic perforation by a transmural and transvalvular migrated retained sponge: Multi-detector computed tomography findings (359 views)
World J Gastroentero (ISSN: 1007-9327, 2219-2840, 1007-9327linking), 2014 Apr 21; 20(15): 4457-4461.
Impact Factor: 2.369
View Export to BibTeX Export to EndNote
Camera L, De Gennaro A, Longobardi M, Masone S, Calabrese E, Del Vecchio W, Persico G, Salvatore M
* A spontaneous strangulated transomental hernia: Prospective and retrospective multi-detector computed tomography findings (275 views)
World J Radiol (ISSN: 1949-8470, 1949-8470electronic), 2014 Feb 28; 6(2): 26-30.
Impact Factor: 0.567
View Export to BibTeX Export to EndNote
Camera L, Calabrese M, Mainenti PP, Masone S, Vecchio WD, Persico G, Salvatore M
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World J Radiol (ISSN: 1949-8470, 1949-8470electronic), 2012 Oct 28; 4(10): 439-442.
Impact Factor: 0.567
View Export to BibTeX Export to EndNote
Zeppa P, Barra E, Napolitano V, Cozzolino I, Troncone G, Picardi M, De Renzo A, Mainenti PP, Vetrani A, Palombini L
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Impact Factor: 1.16
View Export to BibTeX Export to EndNote
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View Export to BibTeX Export to EndNote
6 Records (6 excluding Abstracts).
Total impact factor: 7.701 (7.701 excluding Abstracts).
Total 5 year impact factor: 7.787 (7.787 excluding Abstracts).
Total impact factor: 7.701 (7.701 excluding Abstracts).
Total 5 year impact factor: 7.787 (7.787 excluding Abstracts).
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