Treatment Options for Duodenal Perforation

Duodenal perforation, commonly caused by peptic ulcer disease, is a frequent and serious surgical emergency. This condition typically develops rapidly, progresses quickly, and requires prompt medical attention. Without timely and appropriate treatment, it can be life-threatening. Regardless of the type of perforation, surgical intervention remains the primary treatment method. Surgeons may opt for either a simple perforation repair or a more extensive distal gastrectomy, depending on the patient's specific condition. In some cases, closure of the duodenal stump is also performed during surgery.

Postoperative Care and Recovery

After surgery, it is crucial for patients to receive aggressive antibiotic therapy to prevent infection. Nutritional support is also a key component of postoperative care, helping the body heal and regain strength. Early mobilization is strongly encouraged to reduce complications and stimulate gastrointestinal function. Additionally, acid-suppressive medications are routinely prescribed to protect the gastrointestinal mucosa and promote ulcer healing.

Types of Duodenal Ulcer Perforation

Free Perforation vs. Contained Perforation

Duodenal ulcer perforation most commonly affects middle-aged and elderly men. It is classified into two main types: free perforation and contained (or localized) perforation. In free perforation, the contents of the duodenum spill into the abdominal cavity, potentially causing widespread peritonitis. In contrast, contained perforation occurs when the leak is confined by surrounding organs or the greater omentum, limiting the spread of intestinal contents into the peritoneal cavity.