STUDY OF THE ROLE OF JEJUNAL SEROSAL PATCH IN THE MANAGEMENT OF LARGE GASTRODUODENAL PERFORATIONS | ||||
The Egyptian Journal of Surgery | ||||
Volume 31, Issue 3, July 2012, Page 116-122 PDF (745.91 K) | ||||
Document Type: Original Article | ||||
DOI: 10.21608/ejsur.2012.367258 | ||||
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Authors | ||||
Magdy Sorour1; Abdel-Hamid Ghazal1; Mohamed Kassem* 1; El-Sayed El-Khashab1; Gihan Shehata2 | ||||
1General Surgery Department, Faculty of Medicine, Alexandria University, Egypt | ||||
2Medical Informatics and Medical Statistics Department, Medical Research Institute, Alexandria University, Egypt | ||||
Abstract | ||||
Background: Duodenal ulcer perforations are a common surgical emergency and a common cause of peritonitis in Egypt. The worldwide mortality rate varies between 1.3 to 20% in different series. Methods: This study was carried out on 25 patients with large (more than 1 cm in size) gastric or duodenal ulcer perforations presented to the Emergency Department at the Main Alexandria University Hospital over a period of six years from May 2005 to April 2011. Patients with large perforations were sorted into two groups according to a newly suggested classification that depends on the size of ulcer perforation noted intra-operatively: Group I (1 cm to 2 cm); and Group II (2 cm to 3 cm). The technique of jejunal serosal patch was used in 20 cases. Results: Most perforations were in the 1st part of the duodenum (80%). Perforations greater than 1 cm and less than 2 cm in size were accounting for 88% (22 cases) while perforations greater than 2 cm and less than 3 cm in size were seen in 12% (3 cases). Overall, the commonest surgery performed was jejunal serosal patch using a loop of the jejunum in 17 of the 22 cases in Group I; and the 3 patients in Group II. Morbidities were found in 52% (13/25). The hospital mortality in our series was 12 % (3 cases). Conclusion: Large gastroduodenal perforations can safely be closed using a jejunal loop as serosal onlay patch. | ||||
Keywords | ||||
Large gastroduodenal perforations; jejunal serosal patch | ||||
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