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| Ultrasonographic Findings of Perforated Duodenal Ulcer |
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| Hyo Seouk Kang, M.D., Byeong Ryong Seoul, M.D.*, Cheoul Heon Cheong, M.D.,*, Eun Rae Jo, M.D.**, Wan Kook Lee, M.D** |
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| Department of Diagnostic Radiology, *Department of General Surgery, **Department of Internal Medicine, Shilla General Hospital |
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| PURPOSE : To evaluate the efficacy of ultrasonography in patients with equivocal (or uncertain) clinical findings of
perforated duodenal ulcer
MATERIALS and METHODS : Ultrasonogrphy of eight patients with clinically suspected perforated duodenal ulcer but
no free gas shadow seen on simple abdomen film was prospectively evaluated and compared with the findings
of fifty normal patients. The distances were measured between: 1) the left lobe of the liver and the duodenum
(hepatoduodenal interface, HDI), 2) the posterior margin of the duodenum and the anterior margin of the pancreas
(pancreaticoduodenal interface, PDI) and 3) the left lobe of the liver and the pancreas through the duodenal
bulb (hepatopancreatic distance, HPD). The echo-pattern of each interface was also evaluated, and the relationship
between echo-pattern and each interface or distance was analyzed in addition to the assessment of statistical
significance.
RESULTS : In the normal subjects (n=50), HDI and PDI echos were asymmetrical, homogeneously curvilinear echogenicity,
and the average distance of HDI, PDI and HPD was 2.60 1.00mm, 2.62 0.70mm and 10.10
3.48mm, respectively. However, in 8 patients with perforated duodenal ulcer, HDI PDI was seen as asymmetrically
inhomogenous, thickened hyperechogenicity just like two crosstie under railroad(???), and the average
distance of HDI, PDI and HPD was 9.38 3.28mm, 7.38 2.03mm and 24.12 4.35mm. There was a statistically
significant difference(p<0.0001) in HDI, PDI and HPD of two groups, the normal group and patient group with
perforated duodenal ulcer.
CONCLUSION : Ultrasonographic findings of patients with perforated duodenal ulcer include symmetrically inhomogenous,
thickened hyperechogenicity in addition to the wider hepatopancreatic distance. |
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| Keyword : Peptic ulcer, complications; Duodenum, perforation; Gastrointestinal tract, US |
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pdf파일 : K20200117.pdf 
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> Journal > Journal Search 
Journal of Korean Society of Ultrasound in Medicine 2001 ; 20 (2) : p.117 - 121
