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  • Title: [Giant duodenal ulcer perforation: a case of innovative repair with an antrum gastric patch].
    Author: Cienfuegos JA, Rotellar F, Valentí V, Arredondo J, Baixauli J, Pedano N, Bellver M, Hernández-Lizoaín JL.
    Journal: Rev Esp Enferm Dig; 2012 Aug; 104(8):436-9. PubMed ID: 23039806.
    Abstract:
    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 17th 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.
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