title: A perforated duodenal ulcer presenting as inferior lead ST elevation following amphetamine use.
abstract: Typical symptoms of duodenal ulcers include epigastric pain, nausea, vomiting, chest pain and shortness of breath. Here we present the case of a 39-year-old man who had a sudden onset of chest and epigastric pain following the use of recreational amphetamines. There were ST changes in the inferior leads of his electrocardiogram, indicating the possibility of a myocardial infarction. Following double contrast computed tomography of the abdomen and an urgent laparotomy, a diagnosis of a perforated duodenal ulcer was made. We discuss the aetiologies, presentation, investigation and treatment of the disorder, and make recommendations on the management.
authors.affiliation: Royal Gwent Hospital, Newport, UK. huwgjones@hotmail.com
authors.forename: H G
authors.initials: HG
authors.lastname: Jones
authors.forename: L
authors.initials: L
authors.lastname: Hopkins
authors.forename: A
authors.initials: A
authors.lastname: Clayton
authors.forename: E
authors.initials: E
authors.lastname: McKain
mesh_terms: D000328:Adult; D019969:Amphetamine-Related Disorders / Q000150:complications*; D003937:Diagnosis, Differential; D004381:Duodenal Ulcer / Q000000981:diagnostic imaging / Q000209:etiology*; D004562:Electrocardiography; D004646:Emphysema / Q000000981:diagnostic imaging; D006801:Humans; D008297:Male; D009203:Myocardial Infarction / Q000000981:diagnostic imaging*; D010439:Peptic Ulcer Perforation / Q000000981:diagnostic imaging / Q000209:etiology*; D014057:Tomography, X-Ray Computed