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[Duodenal ulcer presenting as pneumomediastinum and pneumothorax -- case report]
M J Utzig1, Th Foitzik, H J Buhr
1Chirurgische Klinik und Poliklinik I, Allgemein-, Gefäss- und Thoraxchirurgie, Abteilung für Allgemein- Gefäss- und Thoraxchirurgie, Universitätsklinikum Benjamin Franklin, Freie Universität Berlin. martin.utzig@ukfb.fu-berlin.de
Abstract:
Haemorrhage, penetration and perforation are common complications of peptic ulcers. Free intraabdominal air is seen in 80 % after perforation. Penetration into the retroperitoneum with pneumothorax and mediastinal emphysema are rarely observed. We report the case of a 85-year-old female patient with nausea, vomiting and little appetite. During endoscopy of the upper GI-tract she complained about progressive dyspnea. Chest X-ray revealed mediastinal emphysema and pneumothorax. When performing laparotomy, we found a duodenal ulcer, that had penetrated the retroperitoneal space. The patient underwent partial gastrectomy and reconstruction with Billroth-II anastomosis. The postoperative course was uneventful.