Diagnosis of upper gastrointestinal perforation complicated with fistula formation and subphrenic abscess by contrast-enhanced ultrasound: A case report

Figure 1 B-mode ultrasound displayed a right subphrenic mass with heterogeneous echo. L: Liver; A: Abscess.

Figure 2  First-time intravenous contrast-enhanced ultrasound showed that the right subphrenic mass (6. 0 cm × 3.0 cm) presented a large-scale non-enhancement area with slightly enhanced septa inside.

Figure 3  Second-time intravenous contrast-enhanced ultrasound demonstrated that the right subphrenic mass (6. 0 cm × 1.7cm) showed a similar enhancement pattern to the first-time contrast-enhanced ultrasound.

Figure 4 Imaging examinations. A: Intracavitary contrast-enhanced ultrasound (ICCEUS) displayed the process of ultrasound contrast agent (UCA) injection through the drainage tube to the abscess at 52 s; B: At 65 s, ICCEUS revealed a passage connecting the right abscess and left stomach; C: At 106 s, the stomach was filled with UCA on ICCEUS.

Figure 5  Esophagogastroduodenoscopy showed the perforation site (white arrow) located at the duodenal bulb.