Abstract
The patient was a man at the age of 35. One year ago, he suffered from duodenal ulcer which was successfully treated by eradication of Helicobacter pylori (Hp). He visited our outpatient clinic with a sudden onset of upper and right lateral abdominal pain and diagnosed as perforated duodenal ulcer because of rebound tenderness in upper abdomen and opacity of the adipose tissue around the duodenum as well as free air at liver surface as confirmed by computed tomography (CT). Initially, conservative treatment with PPI (proton pump inhibitor) and an antibiotic was chosen, but his complaint and CT findings worsened, which indicated emergency laparotomy. A simple closure of the perforation with omental patch and drainage after irrigation were performed laparoscopically. The patient had a favorable postoperative course and was discharged on postoperatively day 10. The value of HpIgG antibody in blood was below the standard level. He has been under follow-up as an outpatient on PPI and remains well without any abdominal complaints.
