Sonographic diagnosis of peptic ulcer perforation.

A 54-year-old man visited our emergency department with severe upper abdominal pain. Physical examination revealed muscle guarding and rebound tenderness. Emergent sonography revealed marked thickening of the duodenal wall and a linear hyperechoic band involving the entire wall of the duodenal bulb (Figure 1, arrow). Small hyperechoic spots were found continuously moving from the band towards the …