Esophago-gastro-duodenoscopy could be an important tool in the diagnostic dilemma inherent in perforated peptic ulcer: A case report

Acute abdomen is a common and sometimes dramatic clinical condition, which can be fatal if diagnosis is not made in time. Perforated peptic ulcer is a cause of an acute abdomen, which can be diagnosed by imaging investigations. However, erect chest X-ray and CT scan may not always establish the diagnosis. Herein we report a case of a patient with acute abdomen, where radiological imaging and CT scan were not able to provide a clear diagnosis. The patient was diagnosed with perforated peptic ulcer by esophago-gastro-duodenoscopy, and underwent laparotomy to repair the anterior wall duodenal perforation with an omental patch. Early endoscopic evaluation seems to be an essential tool for upper gastrointestinal evaluation in acute abdomen cases with inconclusive imaging results.