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Marginal Ulcer Perforation in a Whipple Survivor: A Rare Long-Term Complication

Arunraj P1, Kolandasamy C1, Prabhakaran R1

  • 1Surgical Gastroenterology, Madras Medical College, Chennai, IND.

Cureus
|September 21, 2022
PubMed

Insights

Long-term pancreaticoduodenectomy complications are rare. This case highlights a rare marginal ulcer perforation 12 years post-surgery, emphasizing the need for vigilance in long-term patient follow-up.

Area of Science:

  • Gastroenterology and Surgical Oncology

Background:

  • Pancreaticoduodenectomy (Whipple procedure) is a complex surgery for upper gastrointestinal cancers.
  • Long-term complications are infrequently documented due to historically poor patient survival rates.

Observation:

  • A patient presented with perforation peritonitis 12 years after pancreaticoduodenectomy for duodenal adenocarcinoma.
  • The perforation was identified at the gastrojejunostomy site, indicative of a marginal ulcer.

Findings:

  • The patient underwent emergency laparotomy with lavage and omental patch closure for the marginal ulcer perforation.
  • Surgical intervention also included truncal vagotomy and a feeding jejunostomy.

Implications:

  • This case underscores the potential for rare, late-onset complications like marginal ulcer perforation after pancreaticoduodenectomy.
  • It highlights the importance of continued surveillance for gastrointestinal complications in long-term survivors of this procedure.
Keywords:
marginal ulcer perforationpancreaticoduodenectomyproton pump inhibitorvagotomywhipple procedure

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