Qiu TT, Fu R, Luo Y, Ling WW. Diagnosis of upper gastrointestinal perforation complicated with fistula formation and subphrenic abscess by contrast-enhanced ultrasound: A case report. World J Clin Cases 2021; 9(29): 8858-8863 [PMID: 34734067 DOI: 10.12998/wjcc.v9.i29.8858]
Corresponding Author of This Article
Wen-Wu Ling, MD, Associate Professor, Department of Medical Ultrasound, West China Hospital of Sichuan University, No. 37 Guoxue Xiang, Chengdu 610041, Sichuan Province, China. lingwenwubing@163.com
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Clin Cases. Oct 16, 2021; 9(29): 8858-8863 Published online Oct 16, 2021. doi: 10.12998/wjcc.v9.i29.8858
Diagnosis of upper gastrointestinal perforation complicated with fistula formation and subphrenic abscess by contrast-enhanced ultrasound: A case report
Ting-Ting Qiu, Rong Fu, Yan Luo, Wen-Wu Ling
Ting-Ting Qiu, Rong Fu, Yan Luo, Wen-Wu Ling, Department of Medical Ultrasound, West China Hospital of Sichuan University, Chengdu 610041, Sichuan Province, China
Author contributions: Ling WW performed the contrast-enhanced ultrasound examination and supervised the writing and revision of the manuscript; Qiu TT performed the literature review and was a major contributor in writing the manuscript; Fu R and Luo Y supported the data collection and manuscript revision; all authors read and approved the final manuscript.
Supported byNational Natural Science Foundation of China (NSFC), No. 82001833; Post-Doctor Research Project, West China Hospital, Sichuan University, No. 2019HXBH014; and Sichuan Science and Technology Program, No. 2020YFS0211.
Informed consent statement: Written informed consent for publication was obtained from the patient.
Conflict-of-interest statement: The authors declare that they have no conflicts of interest to report.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Wen-Wu Ling, MD, Associate Professor, Department of Medical Ultrasound, West China Hospital of Sichuan University, No. 37 Guoxue Xiang, Chengdu 610041, Sichuan Province, China. lingwenwubing@163.com
Received: May 30, 2021 Peer-review started: May 30, 2021 First decision: June 27, 2021 Revised: June 29, 2021 Accepted: August 16, 2021 Article in press: August 16, 2021 Published online: October 16, 2021
Abstract
BACKGROUND
Gastrointestinal perforation complicated by subphrenic abscess is a surgical emergency. Its diagnosis relies mainly on X-ray or computed tomography (CT), while the value of ultrasound, especially contrast-enhanced ultrasound (CEUS), has been underestimated.
CASE SUMMARY
A 37-year-old man presented with fever and edema of the lower extremities for 10 d. He had a history of laparoscopic repair of gastroduodenal perforation 6 mo prior. His first-time intravenous CEUS indicated a diagnosis of subphrenic abscess. He received antibiotic therapy and ultrasound-guided percutaneous drainage of the abscess. However, second-time intravenous CEUS revealed an unsatisfactory therapeutic effect. Intracavitary CEUS was proposed, and this examination detected communication between the abscess and the stomach. Upper gastrointestinal perforation complicated by fistula formation and subphrenic abscess was diagnosed with the help of CEUS. Abdominal CT and esophagogastroduodenoscopy confirmed the diagnosis. The patient recovered after the perforation was repaired by surgery.
CONCLUSION
Intravenous and intracavitary CEUS provides helpful information for the diagnosis of upper gastrointestinal perforation complicated by fistula formation and subphrenic abscess.
Core Tip: Gastrointestinal perforation complicated by subphrenic abscess is a surgical emergency that is diagnosed mainly by X-ray or computed tomography. We present a case diagnosed with upper gastrointestinal perforation complicated by fistula formation and subphrenic abscess, with the rare application of intravenous and intracavitary contrast-enhanced ultrasound (CEUS). This case highlights that CEUS provides helpful information for diagnosis, with the advantages of bedside availability, real-time application, convenience, economical aspect, and lack of radiation.
