A Rare Complication of Dengue Fever: Posterior Duodenal Perforation Leading to Peritonitis

Abstract

Dengue fever is a common infection in tropical and subtropical locations, characterized by fever, headache, muscle and joint pain, and bleeding signs.  This was the case of a 52-year-old male patient who arrived to the emergency department with a 3-day history of high fever and abdominal pain. He had tested positive for the Dengue NS-1 antigen the day before admission. Upon examination, the patient showed disorientation, unstable hemodynamics, and a hard abdomen.An abdominal X-ray revealed pneumoperitoneum, which indicates the presence of air in the abdominal cavity and necessitates an emergency laparotomy. During the surgery, a posterior duodenal perforation and widespread peritonitis were detected. The perforation was closed by a modified Graham's patch technique, followed by omental patching and a gastro-jejunostomy with pylorus exclusion. Unfortunately, despite medical treatment, the patient died on the third day of stay.If such consequences are not detected and treated immediately, they might be fatal.