Omental Patch Repair for Duodenal Ulcer Perforation

Omental Patch Repair for Duodenal Ulcer Perforation

One common complication of duodenal ulcer is perforation. Typically an ulcer which is located in the anterior wall of the duodenum perforates and one is located in the posterior wall bleeds.

Perforation can lead on to peritonitis. Hence it is a surgical emergency. The type of facies ( facial appearance) we get in a patient with terminal stage of peritonitis is called Hippocratic facies.

The diagnosis of perforation peritonitis can  be made from the clinical examination. There will be abdominal rigidity on palpation. Abdominal rigidity is due to the involuntary contraction of abdominal wall muscles.

The investigation of choice to diagnose a case of perforation peritonitis is a plain radio-graph of the abdomen in erect posture. The characteristic finding in a plain radio-graph is free gas under the diaphragm.

The treatment of a perforated duodenal ulcer is closure of the perforation with a patch of the omentum. This is known as Omental patch repair. An abdominal lavage with warm Normal saline or Ringer Lactate is mandatory after the procedure.