TY - JOUR
AR - SCR-2019-5-114
TI - A Novel Approach to Managing Giant Duodenal Ulcer Perforations: Minimizing Ostomies, Maximizing Decompression. A Case Report
AU - Daniel , Gross
AU - Egelko, Aron
AU - Levi, Amelia
AU - Roudnitsky, Valery
JO - Surgical Case Reports
PY - 2019
DA - Tue 05, Nov 2019
SN - 2613-5965
DO - http://dx.doi.org/10.31487/j.SCR.2019.05.114
UR - https://www.sciencerepository.org/a-novel-approach-to-managing-giant-duodenal-uicer-perforations-minimizing-ostomies-maximizing-decompression-a-case-report_SCR-2019-5-114 
KW - Duodenal perforation, duodenal ulcer, duodenal compression, peptic ulcer, ostomy, GJ tube
AB - 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.