Perforation of a duodenal ulcer into a non-parasitic liver cyst: A rare case of a penetrate hole blockaded with conservative medical management

Abstract

An 88-year-old Japanese woman was admitted to our hospital for abdominal pain with a raised inflammatory reaction. Esophagogastroduodenoscopy (EGD) and computed tomography (CT) showed a duodenal ulcer punching a liver cyst. Since neither ascites nor free air were detected on CT and her family did not wish for aggressive medical treatment, the patient received clinical observation and conservative management. Antibiotic and proton-pump inhibitor therapy was effective, and she exhibited an uneventful recovery. A reexamina-tion of EGD and CT confirmed that the fistulous tract between the liver cyst and duodenum was blockaded. © 2014 The Japanese Society of Internal Medicine.