Laparoscopic surgery repair of perforated pre-pyloric gastric ulcer
This is a 48 years old female with history of chronic back pain on multiple pain medications, including aspirin who came into the emergency room with sudden onset of severe upper abdominal pain and found to have significant tenderness on her physical examination. Her abdominal CT scan showed free intraabdominal air and fluid, consistent with perforated viscus. She was taken to the operating room and underwent a diagnostic laparoscopy surgery which demonstrated a large perforated pre-pyloric gastric ulcer with significant intraabdominal fluid. The contaminated intraabdominal fluid was evacuated and the abdominal cavity was irrigated.
This video demonstrates the laparoscopic surgery primary closure of the perforated gastric ulcer in two layers. Subsequently, the integrity of the closure was confirmed with inflation of the stomach via nasogastric tube with diluted blue dye which showed no evidence of extravasation of dye. Then the area was reinforced and patched with greater omentum. Patient was kept NPO with IV antibiotics and nasogastric tube for three days. An upper GI study on day fourth confirmed the passage of contrast through the duodenum with no extravasation or obstruction. Patient was sent home with oral antibiotics and proton pump inhibitors. For information or to make an appointment with Dr Iraniha Laparoscopic Specialist please contact Surgical Oasis Orange County Surgical Center for Same day or next day appointment. Or call us at