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Benign duodenal ulcer penetrating into pancreas, with obstruction of common bile duct [Úlcera duodenal benigna con penetración en cabeza de páncreas, con obstrucción de la vía biliar]

Publicado en:Revista De Cirugia. 73 (3): 347-350 - 2021-01-01 73(3), DOI: 10.35687/S2452-45492021003835

Autores: Páramo Z J; Rubio L L; Benito B S; Ortega F I; López J; Menchero S A

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Aim: To report an atypical presentation of a benign duodenal ulcer that simulates pancreatic neoplasia. Materials and Method: A case of a 83 years old male patient with astenia and jaundice due to a benign duodenal ulcer penetrating into the pancreas with obstruction of common bile duct. Imagining study identified a pancreatic head mass. The patient required one month admission, receiving broad-spectrum antibiotics, parenteral nutrition and intravenous proton pump inhibitors. Discussion and Conclusion: Due to frequent complications associated to this condition, such as haemodynamic failure, sepsis or free peritoneal perforation, surgery is the main treatment. However, in mild cases, as in our patient, conservative management can be considered. Penetration or fistulization to the head of the pancreas is a rare and serious complication of peptic ulcer disease. Its management can be conservative in selected cases where there is no perforation of the ulcer into the peritoneal cavity, nor septic or hemodynamic deterioration. © 2021, Sociedad de Cirujanos de Chile. All rights reserved.

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