Ictericia obstructiva secundaria a úlcera duodenal: A propósito de un caso

INTRODUCTION: Peptic ulcers are acid-induced lesions found in the stomach and duodenum. The prevalence of peptic ulcer disease in the United States is estimated to be 8.4%. OBJECTIVE: Describe an atypical presentation of complicated duodenal ulcer that causes jaundice and review the literature. CASE PRESENTATION: A 42-year-old male patient, who consulted for generalized jaundice and coluria, associated with low back pain treated with non-steroidal anti-inflammatory drugs. In the laboratory, total bilirubin increased to direct prevalence. A magnetic resonance cholangiography was performed that revealed duodenal thickening, with a decrease in its lumen; and a double contrast computed tomography, where thickening of the duodenal walls was observed, without oral contrast leakage. Subsequently, an upper digestive video-endoscopy was performed where a 30 mm duodenal bulb ulcer was observed. The patient presented good evolution with medical treatment, being discharged on the fifth day of hospitalization. DISCUSSION: Jaundice can be caused by a duodenal ulcer that causes obstruction of the common bile duct. Medical treatment may specify in selected patients. In the present case, it was established to opt for medical treatment since the patient presented hemodynamic stability, without signs of generalized peritonitis, with complementary studies in favor of a contained duodenal ulcer without free air. CONCLUSION: We are dealing with a case of duodenal ulcer complicated with jaundice that presented good evolution with medical treatment.