The Korean Journal of Medicine

The Korean Association of Internal Medicine (대한내과학회)
권호 표지

A Case of Abdominal Abscess Mimicking a Tumor Caused by a PerforatedGastric Ulcer

복강 내 종양으로 오인된 농양을 형성한 위궤양 천공 1예

  • Yu, Jung-Hwan (Department of Internal Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine) ;
  • Jang, Sung-Ill (Department of Internal Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine) ;
  • Park, Jung-Soo (Department of Internal Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine) ;
  • Jung, Kyo-Tae (Department of Internal Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine) ;
  • Kim, Joo-Hee (Department of Radiology, Gangnam Severance Hospital, Yonsei University College of Medicine) ;
  • Kim, Ja-Kyung (Department of Internal Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine) ;
  • Lee, Kwan-Sik (Department of Internal Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine)
  • 유정환 (연세대학교 의과대학 강남세브란스병원 소화기내과) ;
  • 장성일 (연세대학교 의과대학 강남세브란스병원 소화기내과) ;
  • 박정수 (연세대학교 의과대학 강남세브란스병원 소화기내과) ;
  • 정교태 (연세대학교 의과대학 강남세브란스병원 소화기내과) ;
  • 김주희 (연세대학교 의과대학 강남세브란스병원 영상의학과) ;
  • 김자경 (연세대학교 의과대학 강남세브란스병원 소화기내과) ;
  • 이관식 (연세대학교 의과대학 강남세브란스병원 소화기내과)
  • Published : 2011.07.01
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Abstract

Gastric ulcer perforation usually results in panperitonitis, which requires surgical treatment. A peritoneal abscess also can occur with gastric ulcer perforation, but it is not a common complication of peptic ulcer disease. Here, we report a peritoneal abscess that mimicked a tumor and was caused by a gastric ulcer and provide a literature review. A 57-year-old woman was admitted to our hospital for evaluation of an abdominal mass found in another hospital, with no signs of infection. She underwent a left lobectomy of the liver due to choledocholithiasis. Abdominal computed tomography (CT) revealed a heterogeneous mass attached to the antrum of the stomach. At endoscopy, we confirmed that the gastric ulcer at the antrum of the stomach caused the abscess. After 4 weeks of antibiotics and proton pump inhibitor treatment, she was cured. In a patient with abdominal pain and a peritoneal abscess of unknown cause, the possibility of peptic ulcer perforation should be considered.

저자들은 복강 내 종양 의심 환자에서 위궤양 천공에 의한 복강 내 농양을 진단하고 약물치료만으로 완치된 예를 경험하여 이를 문헌고찰과 함께 보고하는 바이다.

Keywords

References

  1. Kurata JH, Nogawa AN. Meta-analysis of risk factors for peptic ulcer: nonsteroidal antiinflammatory drugs, Helicobacter pylori, and smoking. J Clin Gastroenterol 1997;24:2-17. https://doi.org/10.1097/00004836-199701000-00002
  2. Behrman SW. Management of complicated peptic ulcer disease. Arch Surg 2005;140:201-208. https://doi.org/10.1001/archsurg.140.2.201
  3. Ramakrishnan K, Salinas RC. Peptic ulcer disease. Am Fam Physician 2007;76:1005-1012.
  4. Martinez JP, Mattu A. Abdominal pain in the elderly. Emerg Med Clin North Am 2006;24:371-388. https://doi.org/10.1016/j.emc.2006.01.010
  5. Ng EK, Lam YH, Sung JJ, et al. Eradication of Helicobacter pylori prevents recurrence of ulcer after simple closure of duodenal ulcer perforation: randomized controlled trial. Ann Surg 2000;231:153-158. https://doi.org/10.1097/00000658-200002000-00001
  6. Abu-Dallo KI, Laufer N, Freund H. Retroperitoneal perforation of duodenal ulcer with abscess formation. Harefuah 1975;88:14-15.
  7. Camilleri L, Lointier P, Pezet D, Fondrinier E, Chipponi J, Mercier R. Retroperitoneal perforation of duodenal ulcer responsible for abscess. Ann Chir 1989;43:388-390.
  8. Catalano D, Troianiello B. Left side abdominal abscess from a retroperitoneal perforation of a duodenal ulcer. Rofo 1984;141:111-113. https://doi.org/10.1055/s-2008-1053098
  9. Edmondson HT, Terry DB Jr. Retroperitoneal abscess from posterior perforation of duodenal ulcer. J Med Assoc Ga 1972;61:374-375.
  10. O'Neal JF. A spontaneous esophageal perforation and duodenal ulcer perforation resulting in a subpulmonic abscess. W V Med J 1994;90:475-476.
  11. Zipfel L, Unrein HD. Life-endangering infantile duodenal ulcer hemorrhage in mediastinal abscess following covered hypopharyngeal perforation. Z Arztl Fortbild (Jena) 1976;70:903-905.
  12. Bukurov S, Pavlovic D. Latent abscess in bursa omentalis after a hidden perforation of peptic ulcer of the stomach. Srp Arh Celok Lek 1955;83:1347-1350.
  13. Moller MH, Shah K, Bendix J, et al. Risk factors in patients surgically treated for peptic ulcer perforation. Scand J Gastroenterol 2009;44:145-152. https://doi.org/10.1080/00365520802401261
  14. Arici C, Dinckan A, Erdogan O, Bozan H, Colak T. Peptic ulcer perforation: an analysis of risk factors. Ulus Travma Derg 2002;8:142-146.
  15. Walgenbach S, Bernhard G, Durr HR, Weis C. Perforation of gastroduodenal ulcer: a risk analysis. Med Klin (Munich) 1992;87:403-407.
  16. Bachev II. Risk factors of complications of peptic ulcer by acute hemorrhage and perforation. Vestn Khir Im I I Grek 1991;146:20-24.