giant duodenal ulcer perforation: a case of innovative repair with an antrum gastric patch perforación de ulcus gigante duodenal: reparación innovadora mediante una plastia del antro gástrico

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ID: 232125
2012
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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.
Antecedentes: el tratamiento de un ulcus duodenal gigante (UDG; > 2 cm) perforado entraña una gran dificultad técnica, por la reparación del gran defecto duodenal; y por la peritonitis sobreañadida. Todas las técnicas descritas se asocian con un índice elevado de dehiscencias y una mortalidad del 15-40%. Describimos por primera vez el caso de un UDG perforado, tratado mediante una gastrectomía subtotal y con una plastia del antro gástrico remanente. Caso clínico: varón de 63 años que se interviene de un UDG perforado en la 2ª porción duodenal asociado con peritonitis severa y disección de la gotiera parieto-cólica derecha retroperitoneo. Se realiza gastrectomía tipo Bilroth II y reparación del defecto duodenal mediante una plastia con la pared del antro gástrico remanente. El paciente fue dado de alta a los 17 días. Discusión: la reparación del defecto duodenal con una plastia del antro gástrico, puede ser una opción muy valiosa en situaciones similares a la descrita. En nuestro conocimiento, se trata de la primera descripción clínica de esta técnica.
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cienfuegos2012revistagiant Use this key to autocite in the manuscript while using SciMatic Manuscript Manager or Thesis Manager
Authors ;Javier A. Cienfuegos;Fernando Rotellar;Víctor Valentí;Jorge Arredondo;Jorge Baixauli;Nicolás Pedano;Manuel Bellver;José Luis Hernández-Lizoain
Journal chemistry of heterocyclic compounds
Year 2012
DOI
DOI not found
URL
http://scielo.isciii.es/scielo.php?script=sci_arttext&pid=S1130-01082012000800009
Keywords
perforation Gastroenterology

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