case_images: PMC11272553_01
case_images: (A) Red patches and papules on the cheeks of this patient, via nasogastric decompression tube; (B) CT scan showed multiple patchy and patchy high-density shadows in both lungs; (C, D) CT scan of duodenal obstruction with perforation, intestinal wall edema is the site of perforation; (E, F) laparoscopic duodenal perforation with abdominal fluid accumulation and surface purulent secretion coverage.
case_images: fped-12-1419355-g001.jpg
case_images: PMC11272553_01_fped-12-1419355-g001.jpg
case_images: F1
case_images: Six months ago, she presented with fatigue and weakness during daily activities, followed by myalgia and rashes on her upper eyelids, cheeks, neck, and the extensor aspects of her limbs (Figure 1A). Despite negative identification of pathogens, her chest and abdominal computed tomography (CT) scans revealed pulmonary inflammation and thickening of the right abdominal intestinal duct wall (Figure 1B). Ten days later, repeat abdominal CT scan indicated duodenal dilation, intestinal and abdominal wall thickening with minimal gas accumulation, perforation in the posterior part of the bulb, multiple enlarged mesenteric lymph nodes, and significant pelvic fluid accumulation (Figures 1C,D). The patient underwent emergent surgery for perforation repair, but failed (Figures 1E,F).