A Case of Giant Descending Duodenal Ulcer Perforation That Was Managed by Multidisciplinary Treatment

Abstract

A 79-year-old man was hospitalized urgently for the treatment of COVID-19 pneumonia. On day 19 of hospitalization, he complained of abdominal pain. Abdominal computed tomography (CT) showed free air and ascites, and we performed emergency surgery. Intraoperatively, we found a giant (5 cm), descending, lateral, duodenal perforation, and performed simple duodenal closure with omentopexy. Leakage observed after the procedure improved with drainage. However, the patient started to vomit. Upper gastrointestinal endoscopic examination revealed duodenal ulcer stenosis, which necessitated re-operation. Although the patient required nutritional therapy and rehabilitation therapy postoperatively, his postoperative course was otherwise uneventful and he was discharged on postoperative day 126 (50 days after the re-operation). In addition to developing complications, the patient’s general condition was also poor, but we were able to successfully manage his condition by multidisciplinary treatment.