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Iatrogenic injury of duodenum: malady of a therapeutic misadventure
  1. Swastik Mishra,
  2. Pankaj Kumar,
  3. Prakash Kumar Sasmal and
  4. Tushar Subhadarshan Mishra
  1. Department of General Surgery, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
  1. Correspondence to Dr Pankaj Kumar; surg_pankaj{at}aiimsbhubaneswar.edu.in

Abstract

Endoscopic procedures are the front-runner of the management of bleeding duodenal ulcer. Rarely, surgical intervention is sought for acute bleeding, not amenable to endoscopic procedures. Oversewing of the gastroduodenal artery at ulcer crater by transduodenal approach is the most acceptable and recommended method of treatment. We describe a case of an intraoperative duodenal injury that occurred during an attempt to oversew the gastroduodenal artery after a duodenotomy, leading to an unsatisfactory and meagre duodenal stump. This case will highlight the intraoperative turmoil, postoperative complications and management of a series of anticipated but unfortunate events that have rendered us wiser in terms of surgical management of a bleeding duodenal ulcer.

  • ulcer
  • stomach and duodenum
  • adult intensive care
  • gastrointestinal surgery
  • general surgery

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Footnotes

  • Contributors SM, PK, PKS and TSM were involved in the care of the patient. SM has worked up the patient and done the follow-up. All authors have contributed substantially to the collection of data, revision of the article and have given necessary intellectual inputs.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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