Perforated Duodenal Ulcer with Blurred Peritonitis in a Colorectal Cancer Patient with Liver Metastasis

We reported a 70-year-old woman, who had colorectal cancer with multiple liver metastasis and palliative surgery as well as chemotherapy were performed, with initial presentation of abdominal distension. Panendoscopy disclosed duodenal ulcer perforation. Emergent laparotomy was performed and revealed the metastatic tumor compressing the perforated wound, which reduced the clinical severity. This case reminds clinicians of the detail examination for the possible medical condition, even in a metastatic colorectal cancer patient who presented with uneventful abdominal discomfort.