title: [Duodenal ulcer presenting as pneumomediastinum and pneumothorax -- case report].
abstract: Haemorrhage, penetration and perforation are common complications of peptic ulcers. Free intraabdominal air is seen in 80 % after perforation. Penetration into the retroperitoneum with pneumothorax and mediastinal emphysema are rarely observed. We report the case of a 85-year-old female patient with nausea, vomiting and little appetite. During endoscopy of the upper GI-tract she complained about progressive dyspnea. Chest X-ray revealed mediastinal emphysema and pneumothorax. When performing laparotomy, we found a duodenal ulcer, that had penetrated the retroperitoneal space. The patient underwent partial gastrectomy and reconstruction with Billroth-II anastomosis. The postoperative course was uneventful.
authors.affiliation: Chirurgische Klinik und Poliklinik I, Allgemein-, Gefäss- und Thoraxchirurgie, Abteilung für Allgemein- Gefäss- und Thoraxchirurgie, Universitätsklinikum Benjamin Franklin, Freie Universität Berlin. martin.utzig@ukfb.fu-berlin.de
authors.forename: M J
authors.initials: MJ
authors.lastname: Utzig
authors.forename: Th
authors.initials: T
authors.lastname: Foitzik
authors.forename: H J
authors.initials: HJ
authors.lastname: Buhr
authors.forename: P
authors.initials: P
authors.lastname: Schneider
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000713:Anastomosis, Roux-en-Y; D003937:Diagnosis, Differential; D004381:Duodenal Ulcer / Q000175:diagnosis* / Q000601:surgery; D004384:Duodenoscopy; D004417:Dyspnea / Q000209:etiology; D005260:Female; D005743:Gastrectomy; D006801:Humans; D008478:Mediastinal Emphysema / Q000209:etiology* / Q000601:surgery; D010439:Peptic Ulcer Perforation / Q000175:diagnosis* / Q000601:surgery; D010538:Peritonitis / Q000209:etiology / Q000601:surgery; D011030:Pneumothorax / Q000209:etiology* / Q000601:surgery; D013352:Subcutaneous Emphysema / Q000209:etiology