Abstract
Giant duodenal ulcer perforation is a complicated disease with high morbidity and mortality under conventional treatment strategy. We report a case of giant duodenal ulcer perforation treated by omental plugging and biliary drainage. The patient was a 61-year-old woman who was admitted to the hospital for back pain and anorexia after nonsteroidal anti-inflammatory drug (NSAID) use. Laboratory data showed leukocytosis (21,900/μl) and a high CRP level (22.39 mg/dl). Abdominal computed tomography (CT) revealed perforation of the duodenum and a confined abscess. The operative findings were giant perforation (5.5 × 3.5cm) of the duodenum and an abscess with biliary perforation. Because of severe adhesion after the radical hysterectomy and left hepatectomy, omental plugging and biliary drainage were performed. Although leakage was observed after operation, it improved rapidly and there was no duodenal stenosis. Omental plugging and biliary drainage are low invasive procedures and may be useful for high risk patients.
