Duodenal Perforation: Imaging Diagnosis, Pathophysiology, and Management
Keywords: Duodenal perforation, retroperitoneal air, CT imaging, peptic ulcer disease, abdominal emergency, duodenal ulcer, NSAIDs, Helicobacter pylori, emergency radiology Introduction Duodenal perforation is a life-threatening abdominal emergency that requires rapid diagnosis and prompt management. It most commonly arises as a complication of peptic ulcer disease and remains a critical diagnostic consideration for radiologists, emergency physicians, surgeons, and trainees preparing for board and licensing examinations. Despite advances in medical therapy for acid-related disorders, duodenal perforation continues to carry significant morbidity and mortality, particularly in elderly patients and those with delayed presentation. This article provides a comprehensive, expert-level review of duodenal perforation , integrating pathophysiology, epidemiology, clinical presentation, imaging features, differential diagnosis, diagnostic strategy, treatment, and prognosis , with direct re...