A rare case of simultaneous giant gastric and duodenal perforation managed by non-classical method- Mikulicz pyloroplasty
Corresponding Author(s) : Dr. Vijay Haralgat Seetharamaiah
International Journal of Allied Medical Sciences and Clinical Research,
Vol. 4 No. 2 (2016): 2016 Volume 4- Issue -2
Abstract
Acid peptic disease (APD) is highly prevalent disease in modern society, with an incidence rate of 5-15%. [1] APD has multiple complications, among them Perforation of the ulcer is the most lethal one, having mortality rate up to 15%. Peptic perforation may be the initial presentation of APD. Perforation of ulcer can be seen in 2-10% of APD patients. [2] Patient’s presenting with simultaneous duodenal and giant gastric perforation is rare entity. [4] Most of these cases are dealt by classical surgical approaches. In this case, an unstable chronic liver disease (CLD) patient with portal hypertension (PHT) presented with giant pyloric perforation and duodenal perforation simultaneously associated with H.pylori infection. Patient was treated with non-classical approach, wherein two perforations were converted into single perforation and closed by Mikulicz Pyloroplasty (MP).
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[1]. Aro P, Storskrubb T, Ronkainen J, et al: Peptic ulcer disease in a general adult population: The Kalixanda study: A random population-based study. Am J Epidemiol 163:1025–1034, 2006.
[2]. Druart ML, Van Hee R, Etienne J, et al: Laparoscopic repair of perforated duodenal ulcer: a prospective multicenter clinical trial.Surg Endosc 1997; 11: 1017–1020.
[3]. Beauchamp, Evers, Mattox: Sabiston text book of surgery 19 th edition, volume 2 page number 1196.
[4]. Sharma AK1, Sharma RK2, Sharma SK2, Soni D2, Singh TP2: Asian J Surg. 2015 Oct; 38(4):239-41. doi: 10.1016/j.asjsur.2013.04.001. Epub 2013 Jun 6.
[5]. Kanai M, Kondoh S, Kuriki H, Mukaiyama H, Mori K, Tanno T. A report of an atypical case of Degos’ disease with multiple perforations of the stomach and small intestine. Nihon Geka Gakkai Zasshi. 1988; 89:1127e1131. [Article in Japanese].
[6]. Grigorov G, Mitov F. A case of double perforation of duodenal ulcer in a young man following cortisone therapy. Khirurgiia (Sofiia). 1968; 21:511e512. [Article in Bulgarian].
[7]. Mynhardt MR. Double duodenal ulcer with perforation following a burn. S Afr Med J. 1951; 25:114e115.
[8]. Chaudhuri M, Chakravorty SB. Simultaneous multiple peptic perforations. J Indian Med Assoc. 1965; 45:276e277.
References
[2]. Druart ML, Van Hee R, Etienne J, et al: Laparoscopic repair of perforated duodenal ulcer: a prospective multicenter clinical trial.Surg Endosc 1997; 11: 1017–1020.
[3]. Beauchamp, Evers, Mattox: Sabiston text book of surgery 19 th edition, volume 2 page number 1196.
[4]. Sharma AK1, Sharma RK2, Sharma SK2, Soni D2, Singh TP2: Asian J Surg. 2015 Oct; 38(4):239-41. doi: 10.1016/j.asjsur.2013.04.001. Epub 2013 Jun 6.
[5]. Kanai M, Kondoh S, Kuriki H, Mukaiyama H, Mori K, Tanno T. A report of an atypical case of Degos’ disease with multiple perforations of the stomach and small intestine. Nihon Geka Gakkai Zasshi. 1988; 89:1127e1131. [Article in Japanese].
[6]. Grigorov G, Mitov F. A case of double perforation of duodenal ulcer in a young man following cortisone therapy. Khirurgiia (Sofiia). 1968; 21:511e512. [Article in Bulgarian].
[7]. Mynhardt MR. Double duodenal ulcer with perforation following a burn. S Afr Med J. 1951; 25:114e115.
[8]. Chaudhuri M, Chakravorty SB. Simultaneous multiple peptic perforations. J Indian Med Assoc. 1965; 45:276e277.