Absence of Imaging Signs in Perforated Peptic Ulcer
Keywords:
perforated peptic ulcer, peptic ulcer, absence, maging signAbstract
Perforated peptic ulcer (PPU) is a serious complication of peptic ulcer disease (PUD) that carries a risk of mortality of up to 30%. Early recognition, adequate resuscitation, and prompt surgical intervention are essential to provide good outcomes. Imaging such as plain film and computed tomography (CT) are frequently used for diagnosis confirmation. Herein, we reported a case of a 55-year-old man who presented with acute abdominal pain five hours before ED arrival. Physical examination showed a flat abdomen without surgical scarring and there was board-like rigidity on palpation. Acute abdominal series revealed no intra-abdominal free air. Subsequent abdominal CT scan with contrast also revealed no pneumoperitoneum. However, he was undergoing surgical intervention based on his clinical features that suggested PPU. The intra-operative finding showed a perforated pre-pyloric ulcer. He was discharged after five days of hospitalization without any complications. This case highlights the significance of clinical signs and symptoms and not solely relying on imaging findings.
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บทความที่ได้รับตีพิมพ์ในวารสารเวชศาสตร์ฉุกเฉินแห่งประเทศไทย ถือเป็นเป็นลิขสิทธิ์ของ วิทยาลัยแพทย์เวชศาสตร์ฉุกเฉินแห่งประเทศไทย
กรณีที่บทความได้รับการตีพิมพ์ในวารสารเวชศาสตร์ฉุกเฉินแห่งประเทศไทยแล้ว จะตีพิมพ์ในรูปแบบอิเล็กทรอนิกส์ ไม่มีสำเนาการพิมพ์ภายหลังหนังสือเผยแพร่เรียบร้อยแล้ว ผู้นิพนธ์ไม่สามารถนำบทความดังกล่าวไปนำเสนอหรือตีพิมพ์ในรูปแบบใดๆ ที่อื่นได้ หากมิได้รับคำอนุญาตจากวารสารเวชศาสตร์ฉุกเฉินแห่งประเทศไทย
