Pneumomediastinum and subcutaneous emphysema after perforation of the duodenum during gastroscopy

Abstract

Abstract The first case of duodenal perforation during gastroscopy is reported. The patient's symptoms were mild in contrast to the dramatic picture of perforated peptic ulcer. He developed a pneumoperitoneum, pneumomediastinum, and, in addition, subcutaneous emphysema of the neck—signs more commonly associated with oesophageal rupture than perforation of the duodenum. The aetiology of these signs and the prevention of this complication are discussed.