DOI: 10.36347/sasjs.2021.v07i08.002

Pages: 411-414

Background: Dorsal perforation due to stomach ulcer is a rare condition and it should always be included in the differential diagnosis of acute upper quadrant pain. Our report evaluates the presentation, diagnosis, management and outcomes of this uncommon acute surgical condition. Case presentation: The aim of this case report was to review the current literature and report on a case involving a 65-year-old Caucasian female presented to the emergency department with persistent right upper abdominal pain, nause, vomiting and loss of appetite. Contrast-enhanced CT scans of abdomen showed a dorsal stomach perforation with free air and contrast intraperitoneal and in retroperitoneal space. A posterior gastric perforation of peptic ulcer was confirmed by exploratory laparotomy; ulcerectomy with primary suture closure was performed. The patient was discharged 25 days after the operation. Conclusions: When pneumoperitoneum was confirmed by radiological examination, posterior perforation of peptic ulcer should be actively excluded in high risk patients. A high index of suspicion is mandatory.