title: Chronic subclinical perforation of a duodenal ulcer presenting with an abdominal abscess in a patient with seronegative rheumatoid arthritis.
abstract: Peptic ulcer disease has been a major problem since the turn of this century with high morbidity and mortality. Perforation is less common, with an estimated incidence of 7-10 per 100 000. We present a young woman with rheumatoid arthritis presenting with anaemia. On work up, she was found to have a chronic abdominal abscess secondary to subclinical perforation of a duodenal ulcer. After undergoing percutaneous drainage, she became haemodynamically unstable and was taken for surgical washout and jejunostomy tube placement. A week later she had a decrease in the size of the abscess and was discharged home with drain and tube feeds. At her follow-up a few weeks later, she was tolerating goal tube feeds.
authors.affiliation: Mayo Clinic, Phoenix, Arizona, USA.
authors.forename: Awais
authors.initials: A
authors.lastname: Ashfaq
authors.affiliation: Department of Surgery, Mayo Clinic, Phoenix, Arizona, USA.
authors.forename: Alyssa B
authors.initials: AB
authors.lastname: Chapital
mesh_terms: D018784:Abdominal Abscess / Q000209:etiology* / Q000601:surgery; D000328:Adult; D000740:Anemia / Q000150:complications*; D001172:Arthritis, Rheumatoid / Q000150:complications*; D004322:Drainage; D004381:Duodenal Ulcer / Q000150:complications*; D004750:Enteral Nutrition; D005260:Female; D006801:Humans; D007582:Jejunostomy; D010439:Peptic Ulcer Perforation / Q000150:complications*