Giant perforations of duodenal ulcer

Over a period of eleven years, eight patients were treated for duodenal ulcer perforation measuring more than one centimetre in diameter. In five of these patients, the perforation was sealed using a jejunal loop as serosal onlay patch; one patient underwent gastrectomy and in two patients catheter duodenostomy was done. Two patients died, both due to renal failure. The six surviving patients were discharged with the advice for a subsequent 'ulcer-curing' operation after six months. Two patients developed life threatening complications during this waiting period and one of these died. Giant perforations of duodenal ulcer can safely be closed using a jejunal loop as serosal patch. Delay in doing the second stage definitive surgery for the ulcer may be dangerous.