CLINICAL PRESENTATION, POSTOPERATIVE COMPLICATIONS AND RISK FACTORS OF DUODENAL LEAKAGE AFTER GRAHAM OMENTOPEXY FOR DUODENAL ULCER PERFORATION DUODENAL ULCER

Main Article Content

Rizwan Ali
Ahmed Hussain Pathan
Imtiaz Ali Langah
Muhammad Ghazi Asad Khan
Imtiaz Ali Soomro
Shah Nawaz Khatti

Keywords

Graham omentopexy, duodenal rupture, complications, anastomotic leakage

Abstract

Background: Perforations in the duodenum are a common surgical emergency that carry a high risk of morbidity and death. Helicobacter pylori infection is the main cause of duodenal ulcers, yet long-term use of non-steroidal anti-inflammatory medicines (NSAIDs) can also contribute to the formation of ulcers. The standard treatment for duodenal ulcer perforation is Graham omentopexy. However, 9% of patients experience leakage following this treatment, which has a 44.4% fatality rate.


Objective: To examine the clinical symptoms at presentation, postoperative complications, and risk factors linked with duodenal leakage after Graham omentopexy for perforated duodenal ulcer.


Study design: cross sectional study


Place and Duration: This study was conducted in Liaquat University Hospital Hyderabad/Jamshoro from January 2023 to January 2024


Methodology: Purposive sampling with non-probability technique was used. All patients, regardless of gender, who received emergency surgery for duodenal perforation over the age of twelve years were included in the study. A thorough history and physical examination were performed, and vital signs as well as information regarding duration of symptoms prior to presentation were gathered using a premade form.


Results: There were a total of 80 participants of this study. Majority of them were males. All of the participants were aged between 12 to 65 years. The average age calculated was 28.4 years. PT/INR was deranged in 16 (20%) patients. Majority of the participants presented within 24 hours of onset symptoms. Serum albumin levels were low in six (7.5%) patients. Serum creatinine was elevated in 15 (18.75%) individuals. During the exploration, over 1000 cc of contaminated peritoneal fluid was evacuated from 16 (20%) patients.


Conclusion: In summary, wound infection, paralytic ileus, anastomotic leakage, ruptured abdomen, and respiratory failure are frequent complications that follow Graham omentopexy.

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