Alshammery Sahar, Alotaibi Ahmed, Alwhoaibi Eyad
General Surgery Department, King Abdullah Bin Abdulaziz University Hospital, Airport Road, King Khalid International Airport, Riyadh 13412, Saudi Arabia.
J Surg Case Rep. 2025 May 15;2025(5):rjaf272. doi: 10.1093/jscr/rjaf272. eCollection 2025 May.
Contained gastric perforations are rare clinical entities, and their extension into the abdominal wall with subcutaneous collection is an exceptionally uncommon presentation. This report highlights the case of a 56-year-old male with a history of uncontrolled diabetes mellitus, chronic non-steroidal anti-inflammatory drugs use, and smoking, presenting with abdominal pain and swelling. Imaging revealed a multiloculated fluid collection extending from a perforated gastric ulcer into the anterior abdominal wall, forming a subcutaneous abscess. The patient was managed conservatively with antibiotics, antifungals, bedside incision and drainage, and proton pump inhibitors. This case underscores the importance of early recognition of atypical presentations of gastric perforation and the role of multidisciplinary management in achieving favorable outcomes.
局限性胃穿孔是罕见的临床病症,其延伸至腹壁并伴有皮下积液是一种极为罕见的表现形式。本报告重点介绍了一名56岁男性病例,该患者有糖尿病控制不佳、长期使用非甾体类抗炎药和吸烟史,表现为腹痛和肿胀。影像学检查显示,一个多房性液体积聚从穿孔的胃溃疡延伸至前腹壁,形成皮下脓肿。该患者接受了抗生素、抗真菌药物、床边切开引流及质子泵抑制剂的保守治疗。本病例强调了早期识别胃穿孔非典型表现的重要性以及多学科管理在取得良好治疗效果中的作用。