PMC7876995_01
Contrast enhanced CT abdominal scan that showed a dilated stomach with hyperdense material of hematic nature in the lumen. At the level of the pyloric portion we found irregularly thickened walls associated with a small fluid collection and bubbles of free air (arrows).
gr1.jpg
PMC7876995_01_gr1.jpg
fig0005
At the level of the pyloric portion we found irregularly thickened walls associated with a small fluid collection and bubbles of free air (Fig. 1).
Intraoperative findings during laparoscopic exploration. a, b) we can see a covered perforation with no free fluid in the abdominal cavity. c, d) only blunt dissection of gallbladder detects the large duodenal perforation requiring conversion to open surgery.
gr2.jpg
PMC7876995_01_gr2.jpg
fig0010
On exploratory laparoscopy we found a large perforation (about 5 cm of size) in the first duodenum portion (Fig. 2).