{
    "abstract": "Stress ulcers in the upper gastrointestinal tract can arise from pathologies related to erosive or inflammatory insults in critically ill patients. The relationship between stressful bodily events and the ischemia and perforation of stress ulcers is poorly understood.\nWe present a case of perforated stress ulcer following an abortion that was treated by dilatation and curettage (D&C) and complicated by a coronavirus disease 2019 (COVID-19) infection.\nA 40-year-old lady presented to the emergency room complaining of diffuse abdominal pain, she was recently diagnosed with an incomplete abortion and managed via a D&C procedure in an external hospital. A computed tomography (CT) scan was done at our center for the abdomen and pelvis, showing extensive pneumoperitoneum, which brought the radiologist's attention to suspect a small bowel perforation presumably accompanying a uterine perforation secondary to the D&C. There were no obvious signs of pelvic small bowel perforation in the initial CT images. The perforated duodenal stress ulcer was diagnosed the next day by a new CT scan following oral contrast ingestion and managed surgically by repair and omental patch, and no other bowel perforations were found upon surgical exploration. After the surgery, the patient was diagnosed with COVID-19, and her clinical status deteriorated gradually during the following week, and she passed away from a cardiac arrest.\nIt is unclear whether septic abortion or COVID-19 has resulted in stress ulcer perforation in our patient. This case report highlights the importance of raising early suspicion in the diagnosis of stress ulcer perforation in critically ill patients to reduce the risk of morbidity and mortality.",
    "authors": [
        {
            "affiliation": "Department of Diagnostic Radiology and Nuclear Medicine, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan.",
            "firstname": "Naser",
            "initials": "N",
            "lastname": "Obeidat"
        },
        {
            "affiliation": "Department of Surgery, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan.",
            "firstname": "Ghaith",
            "initials": "G",
            "lastname": "Heilat"
        },
        {
            "affiliation": "Department of Diagnostic Radiology and Nuclear Medicine, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan.",
            "firstname": "Tarek",
            "initials": "T",
            "lastname": "Ajam"
        },
        {
            "affiliation": "Department of Diagnostic Radiology and Nuclear Medicine, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan.",
            "firstname": "Hamzeh",
            "initials": "H",
            "lastname": "Al-Zoubi"
        }
    ],
    "conclusions": "It is unclear whether septic abortion or COVID-19 has resulted in stress ulcer perforation in our patient. This case report highlights the importance of raising early suspicion in the diagnosis of stress ulcer perforation in critically ill patients to reduce the risk of morbidity and mortality.",
    "copyrights": "\u00a9 2023 Naser Obeidat, Ghaith Heilat, Tarek Ajam, Hamzeh Al-Zoubi.",
    "doi": "10.5455/medarh.2023.77.155-157\n10.1016/0002-9610(69)90011-7\n10.1056/nejm197410312911801\n10.1176/jnp.10.2.230a\n10.1053/j.gastro.2008.05.030\n10.1016/S0039-6109(16)41099-6\n10.1016/S0039-6109(16)41099-6\n10.1007/s00134-004-2207-7\n10.1016/j.ijgo.2011.05.027\n10.1016/j.clinre.2020.07.025\n10.1093/ofid/ofaa105/5811022\n10.1097/SLA.0000000000003958",
    "journal": "Medical archives (Sarajevo, Bosnia and Herzegovina)",
    "keywords": [
        "COVID-19",
        "Duodenal ulcer",
        "computed-tomography",
        "pneumoperitoneum"
    ],
    "methods": null,
    "publication_date": "2023-06-01",
    "pubmed_id": "37260798\n5771525\n2878727\n4547133\n9722327\n18549814\n8355382\n793064\n793064\n15007546\n21885049\n32888875\n32284951\n32433280",
    "results": null,
    "title": "Perforated Stress Ulcer of the Duodenum: a Case of an Unexpected Diagnosis in a COVID-19 Patient Following Dilatation and Curettage Procedure.",
    "xml": "<Element 'PubmedArticle' at 0x7885061c9710>"
}