# Contained gastric perforation leading to a rare abdominal subcutaneous collection: a case report

**Authors:** Sahar Alshammery, Ahmed Alotaibi, Eyad Alwhoaibi

PMC · DOI: 10.1093/jscr/rjaf272 · Journal of Surgical Case Reports · 2025-05-15

## TL;DR

A rare case of contained gastric perforation extending into the abdominal wall is reported, emphasizing the need for early recognition and multidisciplinary care.

## Contribution

This case report presents a rare clinical presentation of gastric perforation extending into the abdominal wall with subcutaneous collection.

## Key findings

- A 56-year-old male presented with a gastric ulcer perforation extending into the anterior abdominal wall as a subcutaneous abscess.
- Conservative management with antibiotics, antifungals, and drainage led to a favorable outcome.
- The case highlights the importance of recognizing atypical presentations of gastric perforation.

## Abstract

Contained gastric perforations are rare clinical entities, and their extension into the abdominal wall with subcutaneous collection is an exceptionally uncommon presentation. This report highlights the case of a 56-year-old male with a history of uncontrolled diabetes mellitus, chronic non-steroidal anti-inflammatory drugs use, and smoking, presenting with abdominal pain and swelling. Imaging revealed a multiloculated fluid collection extending from a perforated gastric ulcer into the anterior abdominal wall, forming a subcutaneous abscess. The patient was managed conservatively with antibiotics, antifungals, bedside incision and drainage, and proton pump inhibitors. This case underscores the importance of early recognition of atypical presentations of gastric perforation and the role of multidisciplinary management in achieving favorable outcomes.

## Linked entities

- **Diseases:** diabetes mellitus (MONDO:0005015), gastric ulcer (MONDO:0001126)

## Full-text entities

- **Genes:** CRP (C-reactive protein) [NCBI Gene 1401] {aka PTX1}
- **Diseases:** ulcer (MESH:D014456), swelling (MESH:D004487), duodenal ulcer (MESH:D004381), abdominal abscess (MESH:D018784), bleeding (MESH:D006470), peritonitis (MESH:D010538), erythema (MESH:D004890), hematemesis (MESH:D006396), peptic ulcer perforations (MESH:D010439), subcutaneous (MESH:D013352), type 2 diabetes mellitus (MESH:D003924), Gastric perforations (MESH:D013274), abdominal swelling (MESH:D000007), abscess (MESH:D000038), weight loss (MESH:D015431), pain (MESH:D010146), nausea (MESH:D009325), gastric ulcer (MESH:D013276), gastrointestinal (GI) bleed (MESH:D006471), abdominal pain (MESH:D015746), perforation (MESH:D057112), duodenal perforation (MESH:D004382), contrast leak (MESH:D005119), fever (MESH:D005334), inflammatory bowel disease (MESH:D015212), diabetes (MESH:D003920), melena (MESH:D008551), PUD (MESH:D010437), tenderness (MESH:D063806), vomiting (MESH:D014839), Gastric (MESH:D013272)
- **Chemicals:** amoxicillin (MESH:D000658), omeprazole (MESH:D009853), pantoprazole (MESH:D000077402), clarithromycin (MESH:D017291), piperacillin-tazobactam (MESH:D000077725)
- **Species:** Candida albicans (species) [taxon 5476], Homo sapiens (human, species) [taxon 9606], Helicobacter pylori (species) [taxon 210]

## Full text

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## Figures

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## References

3 references — full list in the complete paper: https://tomesphere.com/paper/PMC12078926/full.md

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Source: https://tomesphere.com/paper/PMC12078926