[A method of arresting bleeding from penetrating duodenal ulcer]

In operations for bleeding ulcers a situation often occurs in which the surgeon has to restrict the operation to a small intervention. The danger of a recurrent hemorrhage is the main shortcoming of the existing palliative operations. Excision of the ulcer and subsequent closure of the defect is the only measure after which the bleeding will not recur. However, in penetrating ulcers of the posterior wall or its adjacent areas, this operation cannot be carried out practically. At the same time, it is just these ulcer that are the most common sources of bleeding. The author suggests the following method for such cases: without performing anterior gastroduodenotomy, the upper and lateral borders of the ulcer are excised, the bleeding vessel is ligated, and the separated duodenal wall is sutured to the inferior border of the ulcer and peritotration is conducted. The suggested method makes it possible to exclude the ulcer from the gastrointestinal lumen, which ensures reliable hemostasis. Good results were produced in 3 cases in which the method was applied. A description of the method had not been encountered in the available literature.