article = {SCR-2019-5-114}
title = {A Novel Approach to Managing Giant Duodenal Ulcer Perforations: Minimizing Ostomies, Maximizing Decompression. A Case Report}
journal = {Surgical Case Reports}
year = {2019}
issn = {2613-5965}
doi = {http://dx.doi.org/10.31487/j.SCR.2019.05.114}
url = {https://www.sciencerepository.org/a-novel-approach-to-managing-giant-duodenal-uicer-perforations-minimizing-ostomies-maximizing-decompression-a-case-report_SCR-2019-5-114 
author = {Daniel  Gross,Egelko Aron,Levi Amelia,Roudnitsky Valery,}
keywords = {Duodenal perforation, duodenal ulcer, duodenal compression, peptic ulcer, ostomy, GJ tube}
abstract ={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.}