scholarly journals Falciform ligament use in perforated duodenal ulcer repair: a case report and literature review

2020 ◽  
Vol 2020 (11) ◽  
Author(s):  
Amr Elgazar ◽  
Ahmed K Awad ◽  
Sheref A Elseidy
Keyword(s):  
Duodenal Ulcer ◽  
Abdominal Cavity ◽  
Clinical Status ◽  
Laparoscopic Approach ◽  
Greater Omentum ◽  
Falciform Ligament ◽  
Perforated Duodenal Ulcer ◽  
Duodenal Ulcers ◽  
Omental Patch ◽  
Surgical Conditions

Abstract Acute perforated duodenal ulcers are considered one of the most encountered emergency surgical conditions leading to mortality. Different approaches have been proposed for management based on the clinical status of the patient. The use of omental patch closure is widely accepted either via an open or laparoscopic approach. However, not all patients are candidates owing to the availability and viability of the greater omentum. In these patients, the falciform ligament can be used as an alternative and efficient method for repair. In this case, we present a male patient with a perforated ulcer in the first part of the duodenum which was managed by falciform ligament patch instead of the usual omental patch. In cases of a deficient or unhealthy greater omentum, or if it cannot be brought in the upper part of the abdominal cavity due to severe adhesions, the falciform ligament can be used efficiently in the closure of perforated duodenal ulcer.

LAPAROSCOPIC REPAIR OF PERFORATED DUODENAL ULCER PATCH VERSUS CONVENTIONAL SURGERY

2019 ◽  
Vol 3 (1) ◽  
Author(s):  
Dr. Anil Kumar Saxena ◽  
Dr. Devi Das Verma
Keyword(s):  
Duodenal Ulcer ◽  
Laparoscopic Repair ◽  
Open Repair ◽  
Wound Dehiscence ◽  
Duodenal Perforation ◽  
Perforated Duodenal Ulcer ◽  
Conventional Surgery ◽  
Duodenal Ulcers ◽  
Duration Of Operation ◽  
Repair Group

Introduction: For many surgeries for duodenal ulcer Laparoscopic repair has become gold standard for many elective procedures such as ant reflux procedures, laparoscopic cholecystectomy and in colorectal surgery. Although in the emergency setting such as in the management of perforated duodenal ulcer Laparoscopic repair has been slow and limited. Since 1990, for the treatment of perforated peptic ulcer Laparoscopic repair has been used which has been widely accepted as an effective method. Duodenal ulcer is defined as a peptic ulcer which develops in the first part of the small intestine called duodenum and usually present as a perforation of acute abdomen. In perforated duodenal symptoms as severe and sudden onset abdominal pain that is worse in right upper quadrant and epigastrium and usually followed by nausea and vomiting. In this situation there is rapid generalization of pain and in examination shows peritonitis with lack of bowel sounds. Aim: The main objective of this study is to evaluate outcome of laparoscopic surgery in comparison with conventional surgery. Material and methods: All the patients with clinically diagnosed with perforated duodenal ulcers presenting within 24 hours of symptoms and undergoing surgery were included during the study period. Total 50 patients were included with age group 15-65 years. All the patients with perforated duodenal ulcers were included which go through either conventional open or laparoscopic without omental patch repair. Result: Total 50 patients were included in these studies which were divided into two group with 25 patients in each group as laparoscopic duodenal perforation repair group and conventional open repair group. Mean duration of operation (in minutes) was 105.4±10.4 in laparoscopic duodenal perforation repair group whereas mean duration of operation (in minutes) was 67.3±8.6 in conventional open repair group. Mean duration of number of doses of analgesics required in laparoscopic group and conventional open group as 9.5±1.7 and 17.2± 3.1 respectively. Out of 25 patients in each group of laparoscopic duodenal perforation repair group and the conventional open repair group the outcome were noted with their post operative complication as shown in table no 5 below.   In Post-operative complications 21(84%) patients in laparoscopic duodenal perforation repair group and 14(56%) patients in conventional open repair group had no complications. 4 (16%) patients in the laparoscopic duodenal perforation repair group and 2(8%) patients in conventional open repair group showed Post-operative complications as chest infection. In the conventional open repair group  patients present with wound dehiscence and wound infection and Wound dehiscence and chest infection were 4(16%) and 5(20%) respectively whereas nil in Laparoscopic duodenal perforation repair group. Conclusion: Duodenal ulcer perforation is a life-threatening emergency which required urgent management for the patients. Due to the advance in duodenal ulcer perforation closure by laparoscopy it becomes popular and favorite choice. With certain criteria, laparoscopic closure of perforated duodenal ulcer is safe and effective though it was associated with longer operating time and had no impact on the outcome. Hence laparoscopic closure was better in comparison to open repair for the earlier returns to normal daily activities. Keywords:  Duodenal ulcer, Laparoscopic repair, Post-operative analgesia, conventional surgery

RESULTS OF THE SUTURE OF THE PERFORATION BY SINGLE-PORT LAPAROSCOPIC SURGERY (SPLS) FOR THE PERFORATED DUODENAL ULCER TREATEMENT

2014 ◽  
pp. 126-132
Author(s):  
Huu Tri Nguyen ◽  
Van Lieu Nguyen
Keyword(s):  
Duodenal Ulcer ◽  
Laparoscopic Surgery ◽  
Single Port ◽  
Previous History ◽  
University Hospital ◽  
Safe Procedure ◽  
Perforated Duodenal Ulcer ◽  
Analgesic Requirement ◽  
Duodenal Ulcers ◽  
The Mean

Background Single-port laparoscopic surgery (SPLS) was increasingly used on several surgical diseases. The aim of this study is evaluation of the results of the suture of the perforation by SPLS for the perforated duodenal ulcer treatement. Methods From January 2012 to July 2014, 35 patients with perforated duodenal ulcers underwent simple suture of the perforations by SPLS at Hue University Hospital and Hue Central Hospital. Results The mean age was 45.9 ± 14.4 years. The sex ratio (male/female) was 16.5 and the mean of BMI was 19.2 ± 2.3. There was one patient (2.9%) with previous history of laparoscopic repair of perforated duodenal ulcer. The duration of the symptoms was 9.9 ± 12.3 hours. 97.1% of patients had the perforations of the anterior wall of the duodenum. The mean size of the perforation was 4.7 ± 3.4 mm (2 – 22mm). 2.9% of patients had the perforations of the posterior wall of the duodenum. The rate of the conversion to the open surgery was 2.9%. The mean operative time was 75.8 ± 33.7min, and the mean hospital stay was 5.8 ± 1.4 days. The mean of the analgesic requirement time was 2.9 ± 0.8 days. The wound length was 1.9 ± 0.1 cm. There was 5.9% of the patients had wound infection. There was no operation-related mortality. Conclusions Simple suture of the perforation by single-port laparoscopic surgery is a feasible and safe procedure, and it may be a scarless surgical technique for perforated duodenal ulcers treatement. Key words: single-port laparoscopic surgery, perforated duodenal ulcer

scholarly journals A perforated duodenal ulcer presenting as inferior lead ST elevation following amphetamine use

2012 ◽  
Vol 94 (4) ◽  
pp. e144-e145 ◽  
Author(s):  
HG Jones ◽  
L Hopkins ◽  
A Clayton ◽  
E McKain
Keyword(s):  
Myocardial Infarction ◽  
Duodenal Ulcer ◽  
Epigastric Pain ◽  
Sudden Onset ◽  
Perforated Duodenal Ulcer ◽  
Shortness Of Breath ◽  
Double Contrast ◽  
Duodenal Ulcers ◽  
Amphetamine Use ◽  
St Elevation

Typical symptoms of duodenal ulcers include epigastric pain, nausea, vomiting, chest pain and shortness of breath. Here we present the case of a 39-year-old man who had a sudden onset of chest and epigastric pain following the use of recreational amphetamines. There were ST changes in the inferior leads of his electrocardiogram, indicating the possibility of a myocardial infarction. Following double contrast computed tomography of the abdomen and an urgent laparotomy, a diagnosis of a perforated duodenal ulcer was made. We discuss the aetiologies, presentation, investigation and treatment of the disorder, and make recommendations on the management.

Laparoscopic omental patch repair of perforated duodenal ulcer with an automated stapler

1994 ◽  
Vol 81 (6) ◽  
pp. 923-923
Author(s):  
A. Wyman ◽  
R. C. Stuart ◽  
A. Darzi ◽  
J. R. T. Monson
Keyword(s):  
Duodenal Ulcer ◽  
Patch Repair ◽  
Perforated Duodenal Ulcer ◽  
Omental Patch

Laparoscopic omental patch repair of perforated duodenal ulcer with an automated stapler

1993 ◽  
Vol 80 (12) ◽  
pp. 1552-1552 ◽  
Author(s):  
A. Darzi ◽  
N. J. Cheshire ◽  
S. S. Somers ◽  
P. A. Super ◽  
P. J. Guillou ◽  
...  
Keyword(s):  
Duodenal Ulcer ◽  
Patch Repair ◽  
Perforated Duodenal Ulcer ◽  
Omental Patch

scholarly journals A unique presentation of perforated duodenal ulcer in a postpartum woman: a case report

2020 ◽  
Vol 2020 (12) ◽  
Author(s):  
Ashali Jain ◽  
Anthony Azzolini ◽  
Seth Kipnis
Keyword(s):  
Duodenal Ulcer ◽  
Gallbladder Disease ◽  
Gallstone Ileus ◽  
Signs And Symptoms ◽  
Postpartum Woman ◽  
Perforated Duodenal Ulcer ◽  
Duodenal Ulcers ◽  
Ulcer Disease ◽  
Post Operation ◽  
In Pregnancy

Abstract Gallbladder disease and peptic ulcer disease (PUD) can present very similarly, and misdiagnosis can often result because of conflicting symptoms. PUD in pregnancy is relatively rare, in part due to the changes in estrogen and progesterone levels. We present a case of a postpartum female, post operation Day 5, with signs/symptoms, physical exam and laboratory work consistent with acute cholecystitis that was found to have a perforated duodenal ulcer intraoperatively. The authors suggest that a fistula would have resulted with ongoing disease. Bilio-enteric fistulas can often form due to ongoing cholelithiasis disease. Cholecystoduodenal fistulas (CDFs) are the most common fistulas to present. It is possible that the incidence of CDF formation secondary to perforated duodenal ulcers is underestimated due to signs and symptoms not presenting until gallstone ileus is diagnosed.

scholarly journals Laparoscopic Repair of Perforated Duodenal Ulcer with Omental Patch

2015 ◽  
Vol 15 (2) ◽  
pp. 215-220
Author(s):  
Mohamed Ibrahim Hassan ◽  
Mohamed Shaaban Khalifa
Keyword(s):  
Duodenal Ulcer ◽  
Laparoscopic Repair ◽  
Perforated Duodenal Ulcer ◽  
Omental Patch

scholarly journals Perforated Duodenal Ulcer in a Young Nepalese Girl: An Infrequent Diagnosis for Age

2021 ◽  
Vol 2021 ◽  
pp. 1-3
Author(s):  
Ashish Lal Shrestha ◽  
Anusha Shrestha
Keyword(s):  
Duodenal Ulcer ◽  
Acute Abdomen ◽  
Patch Repair ◽  
Successful Outcome ◽  
Emergency Laparotomy ◽  
Perforated Duodenal Ulcer ◽  
Gradual Improvement ◽  
Omental Patch ◽  
Abdominal Radiographs ◽  
Strong Suspicion

Perforated duodenal ulcer (PDU) is exceedingly uncommon in children. In a child with acute abdomen and pneumoperitoneum, an appendiceal etiology is more often suspected as a likely cause. Failure or delay to diagnose a PDU can result in significant morbidity and even mortality. We report a case of acute abdomen in a girl with PDU with a successful outcome. A 12-year-old school girl presented to emergency room (ER) with acute generalized abdominal pain for 2 days. Clinical examination revealed florid peritonitis, and abdominal radiographs showed free peritoneal air. At emergency laparotomy, PDU was noted with general peritoneal contamination. Omental patch repair and continued supportive care resulted in gradual improvement. PDU is an uncommon cause of peritonitis in children and poses significant challenges in management. Strong suspicion and prompt appropriate intervention is necessary to avoid untoward outcomes.

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