STUDY OF THE ROLE OF JEJUNAL SEROSAL PATCH IN THE MANAGEMENT OF LARGE GASTRODUODENAL PERFORATIONS

Document Type : Original Article

Authors

1 General Surgery Department, Faculty of Medicine, Alexandria University, Egypt

2 Medical Informatics and Medical Statistics Department, Medical Research Institute, Alexandria University, Egypt

Abstract

Background: Duodenal ulcer perforations are a common surgical emergency and a common cause of 
peritonitis in Egypt. The worldwide mortality rate varies between 1.3 to 20% in different series.
Methods: This study was carried out on 25 patients with large (more than 1 cm in size) gastric or duodenal 
ulcer perforations presented to the Emergency Department at the Main Alexandria University Hospital over 
a period of six years from May 2005 to April 2011. Patients with large perforations were sorted into two 
groups according to a newly suggested classification that depends on the size of ulcer perforation noted 
intra-operatively: Group I (1 cm to 2 cm); and Group II (2 cm to 3 cm). The technique of jejunal serosal patch 
was used in 20 cases. 
Results: Most perforations were in the 1st part of the duodenum (80%). Perforations greater than 1 cm and 
less than 2 cm in size were accounting for 88% (22 cases) while perforations greater than 2 cm and less than 3 
cm in size were seen in 12% (3 cases). Overall, the commonest surgery performed was jejunal serosal patch 
using a loop of the jejunum in 17 of the 22 cases in Group I; and the 3 patients in Group II. Morbidities were 
found in 52% (13/25). The hospital mortality in our series was 12 % (3 cases).
Conclusion: Large gastroduodenal perforations can safely be closed using a jejunal loop as serosal onlay 
patch.

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