Perforation of the Third Segment of the Duodenum in a Patient who Had Taken Steroid Therapy for Wrist Arthritis—A Case Report—

Abstract

A 79-year-old female who had taken NSAID and steroid therapy for wrist arthritis was referred because of an aggravation of upper abdominal pain that occurred after surgery for the wrist arthritis. Abdominal CT revealed free air, ascites, and edema of the jejunum. She was diagnosed with acute peritonitis due to perforation of the upper gastrointestinal tract and underwent an emergency laparotomy. The third segment of the duodenum was perforated. She had neither a duodenal diverticulum nor a foreign body in the duodenum. The patient required a jejunal patch and an omentopexy ; an anastomotic leakage occurred. This report describes a rare case of idiopathic perforation of the third segment of the duodenum.