EJMCR. 2020; 4(8): 263-265

A case report of duodenal and enteric perforation in a single patient

Authors: Ahmed Siddique Ammar, Ahmed Usman Khalid, Ahmed Raza Noumani.

ABSTRACT

Background: The presence of two hollow viscus perforations in a single patient is a rare entity and no case report is available in the literature which shows the finding of duodenal ulcer perforation and enteric perforation in the same patient. Case presentation: A 55-year-old male presented in the emergency department of East Surgical Ward of Mayo Hospital, Lahore, Pakistan, in January 2020 with complaint of abdominal pain and vomiting for the past 3 days and fever for the past 5 days. He was a chronic smoker with a history of 10 pack-years. On examination, he had tachycardia with a pulse rate of 114 beats/minutes and respiratory rate was 30/minutes and his whole abdomen was guarding with absent bowel sounds. X-ray of the chest showed free gas under the right hemidiaphragm. The patient was resuscitated and plan of exploration was made with diagnosis of perforated duodenal ulcer. We found a 0.5 ◊ 0.5 cm perforation on the anterior surface of the first part of the duodenum along with a 1 ◊ 1 cm perforation on antimesenteric surface of ileum that is 1 feet proximal to ileocolic junction. Grahamís patch repair was carried out for duodenal perforation, while loop ileostomy was made for ileal perforation. The patient was discharged on the 5th postoperative day. The reversal of loop ileostomy was carried out after 2 months. Conclusion: In cases of peritonitis, general inspection of the whole gastrointestinal tract plays a very important role as more than one hollow viscus perforation can be found in a single patient which can be missed and can lead to peritonitis again.

Keywords:
Case report, perforation, duodenal, enteric


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A case report of duodenal and enteric perforation in a single patient


Authors
Ahmed Siddique Ammar
Senior Registrar, General Surgery, MAYO Hospital, Lahore, Pakistan
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Ahmed Usman Khalid
Post Graduate Resident, Hayatabad Medical Complex, Peshawar, Pakistan
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Ahmed Raza Noumani
Senior Registrar, General Surgery, MAYO Hospital, Lahore, Pakistan
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Correspondence to:
. Ahmed Siddique Ammar, Senior Registrar, General Surgery, MAYO Hospital, Lahore Pakistan; asammar1912@gmail.com

Publication history
Received 19 May 2020
Revised 04 Jul 2020
Accepted 11 Jul 2020
Published online 15 Aug 2020
Published in print 26 Aug 2020

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Pubmed Style

Ammar AS, Khalid AU, Noumani AR. A case report of duodenal and enteric perforation in a single patient. EJMCR. 2020; 4(8): 263-265. doi:10.24911/ejmcr/173-1589913065


Web Style

Ammar AS, Khalid AU, Noumani AR. A case report of duodenal and enteric perforation in a single patient. https://www.ejmcr.com/?mno=108543 [Access: September 24, 2020]. doi:10.24911/ejmcr/173-1589913065


AMA (American Medical Association) Style

Ammar AS, Khalid AU, Noumani AR. A case report of duodenal and enteric perforation in a single patient. EJMCR. 2020; 4(8): 263-265. doi:10.24911/ejmcr/173-1589913065


Vancouver/ICMJE Style

Ammar AS, Khalid AU, Noumani AR. A case report of duodenal and enteric perforation in a single patient. EJMCR. (2020), [cited September 24, 2020]; 4(8): 263-265. doi:10.24911/ejmcr/173-1589913065


Harvard Style

Ammar, A. S., Khalid, . A. U. & Noumani, . A. R. (2020) A case report of duodenal and enteric perforation in a single patient. EJMCR, 4 (8), 263-265. doi:10.24911/ejmcr/173-1589913065


Turabian Style

Ammar, Ahmed Siddique, Ahmed Usman Khalid, and Ahmed Raza Noumani. 2020. A case report of duodenal and enteric perforation in a single patient. European Journal of Medical Case Reports, 4 (8), 263-265. doi:10.24911/ejmcr/173-1589913065


Chicago Style

Ammar, Ahmed Siddique, Ahmed Usman Khalid, and Ahmed Raza Noumani. "A case report of duodenal and enteric perforation in a single patient." European Journal of Medical Case Reports 4 (2020), 263-265. doi:10.24911/ejmcr/173-1589913065


MLA (The Modern Language Association) Style

Ammar, Ahmed Siddique, Ahmed Usman Khalid, and Ahmed Raza Noumani. "A case report of duodenal and enteric perforation in a single patient." European Journal of Medical Case Reports 4.8 (2020), 263-265. Print. doi:10.24911/ejmcr/173-1589913065


APA (American Psychological Association) Style

Ammar, A. S., Khalid, . A. U. & Noumani, . A. R. (2020) A case report of duodenal and enteric perforation in a single patient. European Journal of Medical Case Reports, 4 (8), 263-265. doi:10.24911/ejmcr/173-1589913065


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