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Diagnosis of perforated gastric ulcers by ultrasound
L Wallstabe1, R Veitt, T Körner
1Städtisches Klinikum "St. Georg" Leipzig, 2. Klinik für Innere Medizin, Leipzig, Germany.
Insights
Ultrasound can reliably diagnose gastrointestinal perforation, even when X-rays are inconclusive. This imaging technique aids in early detection and treatment of conditions like perforated gastric ulcers.
Area of Science:
- Gastroenterology
- Diagnostic Imaging
Background:
- Gastrointestinal perforation requires prompt diagnosis and treatment for improved patient outcomes.
- Plain abdominal X-rays have limitations in definitively diagnosing perforations, especially in early stages.
Observation:
- A 62-year-old woman presented with sudden, severe abdominal pain.
- Initial diagnostic imaging utilized ultrasound, which successfully identified a gastric perforation.
- Subsequent radiography confirmed pneumoperitoneum but did not localize the perforation site.
Findings:
- Ultrasound demonstrated high reliability in detecting pneumoperitoneum.
- The patient underwent surgery where a perforated gastric ulcer was found and repaired.
- This case highlights ultrasound's efficacy in diagnosing gastrointestinal perforations.
Implications:
- Ultrasound should be considered a valuable tool for the rapid diagnosis of gastrointestinal perforations.
- Early ultrasound diagnosis can expedite treatment and improve patient prognoses.
- Further review of ultrasound findings in perforated gastric and duodenal ulcers is warranted.
Abstract:
Patients with a perforation of the gastrointestinal tract need fast confirmation of diagnosis and early treatment to improve outcome. Plain abdominal x-ray does not always prove the perforation particularly at early stage. We report about a 62 year-old woman complaining of consistent abdominal pain with sudden onset. Ultrasound was taken as first diagnostic measure, revealing a perforation. The leakage was located in the stomach. Radiography confirmed the pneumoperitoneum without indicating the perforated location. During operation the perforated gastric ulcer was found and sutured. This case report points out the reliability of ultrasound in diagnosing a pneumoperitoneum. Additionally it provides a summary of ultrasound signs seen in perforated gastric and duodenal ulcers and a review of literature.