Albert Science International Organization

ARTICLE DESCRIPTION: 

Sarmukh S., Salleh A. A. M., Shaker A. H., Graham omental patch is a safe and reliable technique for treatment of a large double duodenal–jejunal (DJ) junction   perforated ulcers: a case report, Journal of Medical & Health Sciences Research (ASIO-JMHSR), 2020, 4(2): 16-18.

¹ Department of General Surgery, Hospital Serdang, Selangor, Malaysia

^2,3 Department of Surgery, University Putra Malaysia, Selangor, Malaysia

doi: 10.2016-74831794;

DOI Link :: http://doi-ds.org/doilink/11.2020-88129167/

ABSTRACT:

The annual incidence of peptic ulcer ranges from 0.1% to 0.3%. Perforation of duodenal ulcer  carry mortality up to 11 %, with a higher mortality seen in patients over the age of 50 years and in those who present late to the hospital. We reported a case of 48 years old gentleman who presented with acute abdomen with peritonitis.  Exploratory laparotomy was performed revealed a large double perforated ulcers at Duodenal–Jejunal junction (DJ junction) which was successfully repaired with conventional and classical Graham Patch. Various modalities applied including re-laparotomy to establish leaking of Graham Patch repair post operatively; however those shows DJ junction was intact with no sign of leaking. We advocate that conventional Graham Patch repair for DJ Junction perforated ulcer is safe and reliable technique.   

Keywords: Double perforated Ulcer at DJ Junction, Graham Patch.

1. Andrew GH, Management of perforated duodenal ulcer department of Surgery, Surgical Treatment: Evidence-Based and Problem-Oriented. Munich: Zuckschwerdt; 2001. Chapter 2, pp138-202
2.  Ramakrishnan K, Salinas RC, Peptic Ulcer Disease. Am Fam Physician. 2007; 76: 1005-12. 
3. Saber A, Ellabban GM, Gad MA. An unusual presentation of anteriorly perforated duodenal ulcer: a case report. Case Study Case Rep., 2011; 1(2): 53 – 60
4. Taleb AK, Razzaq RA, AL-Kathiri ZO, Management of perforated peptic ulcer in patients at a teaching hospital. Saudi Med J., 2008; 29(2):245-250.
5. Lohsiriwat V, Prapasrivorakul S, Lohsiriwat D, Perforted peptic ulcers: clinical presentation, surgical outcomes, and the accuracy of the Boey scoring system in predicting postoperative morbidity and mortality. WJS, 2009; 33:80-85.
6. Kalyani A, Teoh EM., Sukumar N, Jeiunal Patch Repair of a Duodenal Perforation, Med J Malaysia Vol 60 No 2 June 2005. 237-238
7. Graham RR, The treatment of acute perforated duodenal ulcer, Surg. Gynaecol. Obstet. 137; 64: 235-8.