Sonographic findings in complicated peptic ulcer

Area of Science:

• Gastroenterology
• Diagnostic Imaging
• Abdominal Surgery

Background:

• Peptic ulcers are a common gastrointestinal condition.
• Complicated peptic ulcers, including perforation and penetration, present diagnostic challenges.
• Sonography (ultrasound) is a widely available imaging modality for abdominal evaluation.

Observation:

• This study reports sonographic findings in 7 patients with complicated peptic ulcers.
• Four patients had perforated ulcers, with specific findings such as subphrenic fluid, subhepatic extraluminal fluid, and gallbladder fossa inflammatory masses.
• Ulcer penetration into the liver and pancreas was observed in three patients.

Findings:

• Sonography successfully visualized subphrenic and subhepatic fluid collections in perforated ulcers.
• A sinus tract between the duodenum and liver was identified in one case.
• Penetrating ulcers into the pancreas presented as solid masses, mimicking other pancreatic pathologies on ultrasound.

Implications:

• Sonography is a valuable tool for diagnosing and characterizing complications of peptic ulcer disease.
• Ultrasound can help differentiate between perforated and penetrating ulcers based on specific findings.
• Recognizing sonographic features of penetrating ulcers is crucial for appropriate patient management and surgical planning.