Abstract

CIENFUEGOS, Javier A. et al. Giant duodenal ulcer perforation: a case of innovative repair with an antrum gastric patch. Rev. esp. enferm. dig. [online]. 2012, vol.104, n.8, pp.436-439. ISSN 1130-0108.  https://dx.doi.org/10.4321/S1130-01082012000800009.

Backgrounds: the treatment of a perforated giant duodenal ulcer (GUDs) represents a formidable surgical challenge regarding the duodenal wall defect repair in severe peritonitis setting. A high incidence of dehiscence and hospital mortality (15-40%- has been reported with the majority of the techniques). We report a case of GUDs perforation successfully treated with a subtotal gastrectomy and a gastric patch with the remnant antrum, for repairing the duodenal defect. Case report: a 63-years-old man with antecedents of peptic ulcer disease presents a large duodenal ulcer perforation with 48 hrs delay and associated with severe peritonitis and a retroperitoneal collection. A subtotal gastrectomy with Billroth II reconstruction and reconstruction of the duodenal defect with a patch of the remnant antrum was carried out. The patient was discharged at 17^th postoperative day with good tolerance. Discussion: the duodenal defect repair with a patch of the remant antrum, represents a valid alternative in similar circumstances. To our knowledge, it appears to be the first clinical description of this technique.

Keywords : Giant ulcer; Perforation; Gastric patch; Duodenal repair.

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