Abstract
A 61-year-old man was admitted to our hospital with upper abdominal pain. Laboratory investigations revealed an elevated serum C-reactive protein level. Abdominal computed tomography revealed fluid collection in the lesser sac and a thickened gastric wall, and perforation of a gastric ulcer was suspected. However, upper gastrointestinal endoscopy revealed an ulcerated tumor measuring approximately 2 cm in diameter, located in the anterior duodenal wall in the vicinity of the ampulla of Vater. Based on histopathological examination, this tumor was diagnosed as an adenocarcinoma. The lesser sac abscess could be attributed to perforation of the primary duodenal carcinoma, and endoscopic transgastric drainage was performed. The abscess was successfully drained, and we performed pancreaticoduodenectomy for the duodenal cancer, 6 months later. The patient's postoperative course was uneventful, and he is recurrence-free for 7 years. We report this rare case of a lesser sac abscess secondary to perforation of primary duodenal carcinoma, along with a short literature review.
