GASTRIC PERFORATION MIMICKING ACUTE APPENDICITIS: A CASE REPORT

Abstract

Gastric perforation is a surgical emergency that may present with variable clinical manifestations and pose a diagnostic challenge. Its similarity to other causes of acute abdomen can lead to an incorrect initial diagnosis, particularly when pain is localized in regions distant from the primary site of injury. We present the case of a 40-year-old male patient who developed sudden-onset epigastric abdominal pain with subsequent migration to the right iliac fossa, associated with signs of peritoneal irritation, initially suggesting acute appendicitis. During surgical exploration, purulent fluid and free gastric contents were found within the abdominal cavity, along with a congested cecal appendix. A systematic exploration identified an approximately 1 cm antropyloric gastric perforation, which was repaired using a two-layer suture technique. The postoperative course was uneventful. This case highlights the importance of maintaining a broad differential diagnosis in patients presenting with acute abdomen and performing a thorough intraoperative exploration when surgical findings are inconsistent with the initial diagnostic suspicion.