case_images: PMC11211542_01
case_images: Diagnostic results. (A) The abdominal CT image. The red arrow points to pneumoperitoneum. (B) The upper gastrointestinal imaging finding. The red arrow points to the fistula.
case_images: fmed-11-1403218-g001.jpg
case_images: PMC11211542_01_fmed-11-1403218-g001.jpg
case_images: fig1
case_images: Other symptoms were present, such as localized underglossing of adjacent gastric sinusoids and lateral wall of duodenum, fatty liver and a small amount of fluid accumulated in the abdominopelvic cavity (Figure 1A). For verification of the possibility of a duodenal fistula, ascites was sent to be examined for amylase, and upper gastroenterography was suggestive of a duodenal fistula (Figure 1B).
case_images: Changes before and after treatment. (A) Physical picture before treatment. The blue arrow points to the duodenal fistula. (B) Physical picture after treatment. The blue arrow points to the post-surgical trauma. (C) The post-treatment CT image of abdomen. (D) The upper gastrointestinal imaging result after treatment.
case_images: fmed-11-1403218-g002.jpg
case_images: PMC11211542_01_fmed-11-1403218-g002.jpg
case_images: fig2
case_images: After a clear diagnosis, a nasoenteric nutritional tube was placed under gastroscopy to the junction of duodenum and jejunum, and at the same time, the duodenal fistula was operated by purse-string suture with nylon cords, and nasal feeding was given after the operation, and the patient was discharged after recovery (Figures 2A,B). Twenty days later, the patient was readmitted to the hospital for the discovery of a duodenal fistula for more than 1 month, and a repeat abdominal CT demonstrated hyperdense shadows at the lower edge of the liver and a slight resorption of gas compared to the previous contrast, and there was also a small amount of abdominopelvic effusion after gallbladder and duodenal surgery (Figure 2C). Upper gastrointestinal imaging showed no significant duodenal fistula (Figure 2D).