Evaluation of large duodenal ulcer perforation with special reference to omentopexy and omental plugging

Authors

  • Suman Parihar Department of General Surgery, Geetanjali Medical College & Hospital, Udaipur, Rajasthan
  • P.N. Mathur Department of General Surgery, Geetanjali Medical College & Hospital, Udaipur, Rajasthan
  • C.P. Joshi Department of General Surgery, Geetanjali Medical College & Hospital, Udaipur, Rajasthan

DOI:

https://doi.org/10.18203/2349-2902.isj20161438

Abstract

Background:Duodenal perforation is complication of peptic ulcer disease and is common surgical emergency. The giant perforation (more than 2 cm) with long duration is having high mortality. This study in medical college setup where surgical emergencies are catered all the time is carried out to compare the success between omental plugging and omentopexy in emergency setup. The peptic ulcer disease in southern region of state of Rajasthan is very prevalent, may be because of food habits, smoking, and alcohol consumption.

Methods: The present study is a prospective, non-randomized case series study. The study was under taken in the Department of Surgery; Geetanjali Medical College & Hospital between years 2011 to 2013.Thirty cases who were found to have giant peptic perforation during laparotomy were selected for the study.  Perforations repaired by omtental plugging were taken as cases and those repaired by omentopexy were taken as control.

Results:In our study perforation was common in middle aged patients ranging from 30 to 50 years (56%). Personal habits like smoking and alcohol consumption contribute significantly in causing peptic perforation. In our series two female patients were non-smokers but had history of acid peptic disease. Duration and size of perforation is indicative of peritoneal contamination.

Conclusions:In large duodenal ulcer perforation, the technique of omental plugging for repair is effective and safe. This is a simple technique and can be performed rapidly even in high risk patients in emergency. This effectively closes the perforation and chances immediate re-leak are minimal.  

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Published

2016-12-09

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Section

Original Research Articles