A Novel Approach to Managing Giant Duodenal Ulcer Perforations: Minimizing Ostomies, Maximizing Decompression. A Case Report

Author Info

Daniel Gross Egelko Aron Levi Amelia Roudnitsky Valery

Corresponding Author

Daniel Gross
SUNY Downstate Health Sciences University, 450 Clarkson Ave, Brooklyn, NY 11203

A B S T R A C T

Background: Peptic ulcer perforation is a deadly complication of duodenal ulcers. The literature is still sparse in terms of giant duodenal perforations. There exist a variety of techniques to decompress the duodenum after repair which leave the patient with multiple ostomies that require extensive postoperative care. Case presentation: In this case we present a patient with AIDS who was found to have a large duodenal ulcer perforation. Intraoperatively the fragility of the patient’s duodenum warranted a method of decompression that would keep the integrity of the duodenal tissue. The common method of lateral duodenostomy was not the best option and instead a gastro-jejunal feeding tube was altered into a gastroduodenal tube to avoid creating another ostomy. Postoperatively she did not show signs of leak, but eventually died from sepsis secondary to fulminant AIDS. Conclusions: We propose this technique as a novel method of decompressing the duodenum. This new method eliminates the need for excessive ostomies and has the possibility to make the postoperative transition simpler.

Article Info

Article Type

Case Report

Publication history

Received: Sun 06, Oct 2019
Accepted: Thu 24, Oct 2019
Published: Tue 05, Nov 2019

Copyright

© 2023 Daniel Gross. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Hosting by Science Repository.
DOI: 10.31487/j.SCR.2019.05.114