Fournier’s Gangrene and Pneumothorax Secondary to Nontraumatic Duodenal Perforation

Peptic ulcer disease (PUD) results from erosion and ulceration of the upper digestive tract mucosa. Clinical presentations can vary from asymptomatic to severe complications such as perforation, strictures, or bleeding. Perforation can release enteric contents and gas into the abdomen, leading to in...

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Main Authors: Ayman Shehadeh, Amer Mansoor, Jordan Bray, Waed Atallah, Jason Mikhail, Richard Spinale, Angad Pordal
Format: Article
Language:English
Published: Wiley 2025-01-01
Series:Case Reports in Surgery
Online Access:http://dx.doi.org/10.1155/cris/3027477
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author Ayman Shehadeh
Amer Mansoor
Jordan Bray
Waed Atallah
Jason Mikhail
Richard Spinale
Angad Pordal
author_facet Ayman Shehadeh
Amer Mansoor
Jordan Bray
Waed Atallah
Jason Mikhail
Richard Spinale
Angad Pordal
author_sort Ayman Shehadeh
collection DOAJ
description Peptic ulcer disease (PUD) results from erosion and ulceration of the upper digestive tract mucosa. Clinical presentations can vary from asymptomatic to severe complications such as perforation, strictures, or bleeding. Perforation can release enteric contents and gas into the abdomen, leading to intra-abdominal sepsis, requiring surgical intervention for source control and repair. We present a case of a 69-year-old male who developed both Fournier’s gangrene and a right-sided pneumothorax secondary to a nontraumatic perforated duodenal ulcer. The patient underwent an emergent thoracostomy, laparotomy with Graham omentoplasty, and extensive debridement with successful outcome. While rare complications like pneumothorax and necrotizing soft tissue infections have been documented, their simultaneous occurrence from a nontraumatic ulcer perforation is unprecedented in literature. Previous reports suggest enteric contents can traverse retroperitoneal fascial planes and peritoneal defects to reach distant anatomical sites as a possible mechanism for these complications. This case highlights the potential for atypical presentations of PUD and the importance of comprehensive evaluation, early recognition, and prompt surgical intervention.
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spelling doaj-art-96463a7d6b844834a3ade010e8afdeaa2025-08-20T03:21:50ZengWileyCase Reports in Surgery2090-69192025-01-01202510.1155/cris/3027477Fournier’s Gangrene and Pneumothorax Secondary to Nontraumatic Duodenal PerforationAyman Shehadeh0Amer Mansoor1Jordan Bray2Waed Atallah3Jason Mikhail4Richard Spinale5Angad Pordal6Department of SurgeryDepartment of SurgeryDepartment of SurgeryDepartment of SurgeryDepartment of SurgeryDepartment of SurgeryDepartment of SurgeryPeptic ulcer disease (PUD) results from erosion and ulceration of the upper digestive tract mucosa. Clinical presentations can vary from asymptomatic to severe complications such as perforation, strictures, or bleeding. Perforation can release enteric contents and gas into the abdomen, leading to intra-abdominal sepsis, requiring surgical intervention for source control and repair. We present a case of a 69-year-old male who developed both Fournier’s gangrene and a right-sided pneumothorax secondary to a nontraumatic perforated duodenal ulcer. The patient underwent an emergent thoracostomy, laparotomy with Graham omentoplasty, and extensive debridement with successful outcome. While rare complications like pneumothorax and necrotizing soft tissue infections have been documented, their simultaneous occurrence from a nontraumatic ulcer perforation is unprecedented in literature. Previous reports suggest enteric contents can traverse retroperitoneal fascial planes and peritoneal defects to reach distant anatomical sites as a possible mechanism for these complications. This case highlights the potential for atypical presentations of PUD and the importance of comprehensive evaluation, early recognition, and prompt surgical intervention.http://dx.doi.org/10.1155/cris/3027477
spellingShingle Ayman Shehadeh
Amer Mansoor
Jordan Bray
Waed Atallah
Jason Mikhail
Richard Spinale
Angad Pordal
Fournier’s Gangrene and Pneumothorax Secondary to Nontraumatic Duodenal Perforation
Case Reports in Surgery
title Fournier’s Gangrene and Pneumothorax Secondary to Nontraumatic Duodenal Perforation
title_full Fournier’s Gangrene and Pneumothorax Secondary to Nontraumatic Duodenal Perforation
title_fullStr Fournier’s Gangrene and Pneumothorax Secondary to Nontraumatic Duodenal Perforation
title_full_unstemmed Fournier’s Gangrene and Pneumothorax Secondary to Nontraumatic Duodenal Perforation
title_short Fournier’s Gangrene and Pneumothorax Secondary to Nontraumatic Duodenal Perforation
title_sort fournier s gangrene and pneumothorax secondary to nontraumatic duodenal perforation
url http://dx.doi.org/10.1155/cris/3027477
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