Duodenal perforations
Claim CME CreditPOINT OF CARE INFORMATION
This CME activity consists of the student reviewing the video of the professor reviewing the case as well as the associated DICOM image set related to the case in question.
Learning Objectives
As a result of participation in this activity, participants should be able to:
- Provide improved patient care.
- Greater knowledge of the imaging characteristics of the patient's disease.
- Understand a better approach to interpretation of studies.
Faculty Disclosure
Mehmet Albayram, MD, Ivan Davis, MD, Mariam Hanna, MD, Anthony Mancuso, MD, Ronald Quisling, MD, Dhanashree Rajderkar, MD, Priya Sharma, MD, Roberta Slater, MD and Joann Stamm, MBA have disclosed that they have no relevant financial relationships. No one else is a position to control content have any financial relationship to disclose.
CME Advisory Committee Disclosure:
Conflict of interest information for the CME Advisory Committee members can be found on the following website: https://cme.ufl.edu/disclosure/.
Continuing Medical Education Credit
Accreditation: The University of Florida College of Medicine is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.
Credit: The University of Florida College of Medicine designates this enduring material for a maximum of 0.5 AMA PRA Category 1 Credits. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
CB1506-Duodenal perforations
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CB1506-Duodenal perforations
Case ReportHistory
Exam
Findings
LOWER THORAX
The lung bases are clear without focal consolidation or pleural effusion. The heart is normal in size without pericardial effusion.
BONE WINDOWS
There are no fractures. There are no lytic or blastic lesions.
HEPATOBILIARY
There is no discrete liver laceration. There is periportal edema present. The gallbladder is not distended.
PANCREAS
The pancreas demonstrates homogeneous enhancement without a focal parenchymal lesion or discrete laceration; however, given the adjacent injury to the duodenum pancreatic injury must be considered.
SPLEEN
There is normal enhancement pattern of the spleen.
ADRENALS
The adrenal glands are normal.
KIDNEYS/URETERS
The kidney enhanced symmetrically without hydrouteronephrosis. There is no renal laceration or contusion.
PELVIC ORGANS/BLADDER
The bladder distended but otherwise normal.
PERITONEUM
There is small volume intraperitoneal free air present.
There is large volume free fluid within the abdomen which measures above that of simple fluid density raising a concern for hemoperitoneum.
VESSELS
There is no active arterial bleed definitively seen. The IVC is not flattened.
GI TRACT
There is hypodensity concerning for possible discontinuity of the lateral wall of the mid second portion duodenum raising a concerning for rupture.
There is no evidence of active arterial extravasation within or adjacent to the duodenum or in the right aspect of the retroperitoneum. The third and fourth portions of the duodenum are not significantly distended. There is no dilatation of remaining small bowel or colon.
SOFT TISSUES
There are no foreign bodies. There is no laceration of the soft tissues.
