Korean J Gastrointest Endosc.  2006 Oct;33(4):235-239.

A Case of the Duodenal Bulb Abscess

• Chung JI
• Chang HJ
• Lee SH
• Cho DS
• Kim SW
• Cha SC
• Cho YG
• Seok YC
• Ku JH
• Kang HJ

Abstract

Duodenal abscess is a rarely reported disease throughout the entire world. Duodenal abscesses are developed mostly from the complication of duodenal ulcer perforation, and only small percentage of duodenal abscesses are the result of cholecysto-duodenal fistula which was made by gall bladder perforation. We report a 84-year-old male patient who presented to the emergency department with severe anorexia and generalized weakness for 2 weeks. The upper gastrointestinal endoscopy done and revealed a protruding mass at the lesser curvature of the duodenal bulb. As soon as the mass was punched with a biopsy forceps, a large amount of abscess began to pour out into the intestinal lumen. Abdominal CT scan demonstrated the presence of an air-fluid level the in gall bladder and also abscess in the porta hepatitis which was located between the gall bladder and the duodenum. Because the patient refused any surgical intervention, we treated him conservatively with intravenous antibiotics. Patient's symptom of anorexia was slowly resolved, and patient was discharged 10 days later.

Keyword

Duodenal bulb abscess; Endoscopy

MeSH Terms

Abscess*
Aged, 80 and over
Anorexia
Anti-Bacterial Agents
Biopsy
Duodenal Ulcer
Duodenum
Emergency Service, Hospital
Endoscopy
Endoscopy, Gastrointestinal
Fistula
Hepatitis
Humans
Male
Surgical Instruments
Tomography, X-Ray Computed
Urinary Bladder
Anti-Bacterial Agents