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Atypical epigastric pain: Case Report

Fabio Pulighe

Ospedale San Francesco, Nuoro, Italy

E-mail : bhuvaneswari.bibleraaj@uhsm.nhs.uk

Gian Pietro Gusai

Ospedale San Francesco, Nuoro, Italy

Alejandro Serrablo Requejo

Hospital Miguel Servet, Zaragoza, Spain

DOI: 10.15761/CRIS.1000129

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Case report

A 23-year-old man, with no history of medical or surgical disease arrive to our hospital with the presence of epigastric abdominal pain after a car accident. On examination, he was afebrile with an epigastric localized visceral pain and mild tenderness in the same area. His laboratory studies showed normal level of haemoglobin, white blood cell count of 14,400/mm3 with 86% neutrophils and a C-reactive protein of 11.6 mg/ dL.

The patient was then submitted to a CT scan (Figure 1) that showed a large, irregularly shaped deep ulceration on the second duodenum (Figure 2). What is the most likely diagnosis and hoe should it be managed?

Figure 1. Duodenal Trauma – 1

Figure 2. Duodenal Trauma – 2

Discussion

The patient was then submitted to ad urgent surgery and treated with a complete gastric exclusion performed with Billroth II gastro-enteric bypass, suture of duodenum and bilious exclusion with positioning of Kehr drainage (Figure 3).

Figure 3. Duodenal Trauma - 3

The patient had uneventful postoperative course and was discharged at twelve postoperative day. I was then submitted to a Kehr removal after 1 month later.

Conflict of Interest

Fabio Pulighe and Gian Pietro Gusai contributed to the writing of the text.

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Article Type

Case Report

Publication history

Received date: February 01, 2020
Accepted date: February 11, 2020
Published date: February 14, 2020

Copyright

©2020 Pulighe F. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Citation

Pulighe F, Gusai1 GP, Requejo AS. (2020) Atypical epigastric pain: Case Report. Case Rep Imag Surg 3: doi: 10.15761/CRIS.1000129

Corresponding author

Fabio Pulighe

Ospedale San Francesco, Nuoro, Italy.

E-mail : bhuvaneswari.bibleraaj@uhsm.nhs.uk

Figure 1. Duodenal Trauma – 1

Figure 2. Duodenal Trauma – 2

Figure 3. Duodenal Trauma - 3