RETROPERITONEAL PERFORATION OF POSTBULBAR DUODENAL ULCER: DIAGNOSIS AND TREATMENT
Abstract
Background. The choice of operative techniques for the treatment of atypical postbulbar duodenal ulcer perforation is not reflected in detail in the current clinical protocol. Objective. Based on clinical observation to evaluate the prospects of an individualized approach to the diagnosis and surgical management of atypical postbulbar duodenal ulcer perforation. Material and methods. This case report describes successful treatment outcomes in an elderly patient with atypical postbulbar duodenal ulcer perforation complicated by right-sided retroperitoneal phlegmon and acute pancreatitis. The diagnostic methods used and the individualized approach to the selection of operative techniques are evaluated. Results. Timely diagnosis of atypical perforation of a postbulbar duodenal ulcer as well as appropriately chosen radical surgical intervention can contribute to patient recovery, even in the most complex cases. Roux-en-Y gastrectomy with duodenostomy, cholecystostomy, and rational drainage of right-sided retroperitoneal phlegmon, alongside with the medical treatment resulted in the patient's recovery. Conclusion. The management of retroperitoneal postbulbar duodenal ulcer perforation requires an individualized surgical approach.
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