Perforated giant duodenal ulcer: a reviewAsri Che Jusoh, Safra Omar, Hazirah Sazali, Suzuanhafizan Omar.
Giant duodenal ulcer is a rare cause for perforated peptic ulcers but is associated with higher morbidity and mortality compared to a smaller ulcer. Despite that, no single surgical approach has yet been shown to be superior to others. This review will discuss options available based on current evidence. The Google Scholar and PubMed databases were searched. The surgical option is divided into resection and non-resection approaches. The latter was further subdivided into omental based, jejunal based, and tube-based repair. Based on a review of literature and analysis, an omental based plug repair with or without triple tube ostomies was associated with much lower morbidity and mortality than others. The resection approach must be reserved for salvage procedure and preferably done in stages.
Key words: duodenal ulcer, peptic ulcer, perforation