STUDY OF DIFFERENT SURGICAL OPTIONS IN CLOSURE OF GIANT DUODENAL ULCER PERFORATIONS

Abstract

Background-
Duodenal ulcer perforations are a common cause of peritonitis.
The classic pedicled omental patch that is performed for
plugging these was first described by Cellan-Jones in 1929,
although it is commonly and wrongly attributed to Graham who
[1] described the use of a free graft of the omentum . In this
procedure, a strand of omentum is drawn over the perforation
and held in place by full thickness sutures placed on either side
of the perforation which has become the 'gold standard'
treatment. But, occasionally we come across large perforations
of duodenal ulcers in which there is the threat of post-operative
leakage following closure by this simple method. Here, other
surgical options like partial gastrectomy, jejunalserosal patch,
gastrojejunostomy or even gastric disconnection may be
[2] necessary for a secure closure .