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

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.