Eight days after first diagnosis of ischemic duodenal ulceration, the patient complained of strong abdominal pain in the upper right quadrant and a CT scan was performed immediately. Newly occurred prominent air trapping in the area between the pancreatic head and the duodenum indicated contained juxtapapillary perforation. Since the patient remained stable, the authors decided not to investigate the contained perforation endoscopically due to the suspected risk of enlargement of the perforation size by air insufflation during the examination. Cross: area between pancreatic head and duodenum; arrow: air trapping indicating juxtapapillary perforation.