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Case Reports
. 2019 Dec 30:34:217.
doi: 10.11604/pamj.2019.34.217.20829. eCollection 2019.

Huge hydro pneumoperitoneum reported as complication of perforated duodenal ulcer with interesting images

Islam Hussam Elrobaa  1 , Abdulhadi Hayder Khan  1 , Muayad Kassim Ahmad  1 , Abraham John Elamatha  1 , Mohamed Darwish Elserhy  1 , Elfatih Eltahir  1 , Khalid Abdulnour Saifeldeen  1
Affiliations
Case Reports

Huge hydro pneumoperitoneum reported as complication of perforated duodenal ulcer with interesting images

Islam Hussam Elrobaa et al. Pan Afr Med J. .

Abstract

This case has interesting images of huge hydro pneumoperitoneum. It is a rare view in the medical practice and a good point to learn one of the complications of perforated duodenal ulcer and failure of omental patch operation. We reported a case of acute abdominal pain with hydro pneumoperitoneum that appeared as an air fluid line in X-ray. The patient had an omental patch surgery. Two days after the operation he got severe abdominal pain. The X-ray images showed significant huge hydro pneumoperitoneum. He underwent urgent surgical intervention for exploration that detected a large amount of gases, a biliary free fluid and a leak from duodenal ulcer. Omental buttressing was then performed.

Keywords: Abdominal pain; hydro pneumoperitoneum; perforated duodenal ulcer.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Figure 1
Figure 1
First X-ray was in ED which showed pneumoperitoneum with air fluid line
Figure 2
Figure 2
Second X-ray was 2 days after the first operation i.e. omental Graham patch operation, which showed a significant huge hydro pneumoperitoneum
Figure 3
Figure 3
CT Scan was 2 days after omental Graham patch operation, showing massive hydro pneumoperitoneum
Figure 4
Figure 4
CT Scan was 2 days after the first operation, omental Graham patch operation, showing massive hydro pneumoperitoneum
Figure 5
Figure 5
Third X-ray was 6 days after the second operation, omental buttressing, that showing no air or fluid in abdominal cavity
See this image and copyright information in PMC

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