Intraperitoneal cavity.This patient, known to have chronic ulcer disease, was admitted to ER with intense epigastric pain and vomiting. Abdominal plain film did not show retroperitoneal air. Endoscopy was performed. Large ulcer was seen in duodenum (left). A hole was noted in the anterior wall (center). Closer examination revealed a perforated ulcer with bile and food content in retroperitoneal cavity. Patient was referred to surgery immediately.
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