What is omentum patch?

Omental patching is a surgical procedure for treating perforated ulcers. It is also called a Graham patch after the surgeon who first performed this technique. This procedure uses a patch of the omentum to repair the injury because it is durable.

How long can you live with a perforated ulcer?

Overall 30-day mortality from perforated peptic ulcer was 25.3%, but it increased from 8.9% among patients younger than 65 years to respectively 28.5% and 46.0% among patients aged 65–79 years and 80+ years (table 2).

What is Laparoscopic omental patch repair?

Seromuscular sutures are generally used during laparoscopic repair of perforated duodenal ulcers. Another variant, used when the omentum is not available (because of previous surgery, necrosis, or unfavorable anatomy), is the Thal patch, in which a loop of jejunum is used to patch the perforation (see the image below).

Can a perforated ulcer heal without surgery?

However complications of peptic ulcer disease either bleeding or perforation still frequently require surgical intervention. Although bleeding peptic ulcers can usually be treated with non-surgical means, 5–10% will require emergent surgery for hemostasis.

What happens if a ulcer ruptures?

An ulcer can go through all the layers of the digestive tract and form a hole (perforation). This is called a perforated ulcer. A perforated ulcer lets food and digestive juices leak out of the digestive tract. This is a serious health problem that needs urgent medical attention.

What is an omentum flap?

The greater omentum is a large peritoneal fold consisting of connective tissue, fat and lymphatics. It is well vascularized with large feeding arteries and draining veins. Because harvesting requires laparotomy, this flap is used infrequently.

Can a perforated ulcer be fatal?

Peptic ulcer perforation is well recognized as a cause of peritonitis and can result in death. Although amenable to surgery, delay in making the correct diagnosis results in increased mortality.

What does a vagotomy do?

A vagotomy is a surgical procedure that removes part of your vagus nerve, which serves many important functions, such as controlling the production of stomach acid. In the past, it was frequently used to treat ulcers, but new medications have made it less common, especially on its own.

Is perforated ulcer an emergency?

Perforated peptic ulcer, with associated peritonitis and sepsis/septic shock, is a medical/surgical emergency requiring rapid evaluation and management [23].

What is omentum patching?

Omental patching is a surgical procedure for treating perforated ulcers. It is also called a Graham patch after the surgeon who first performed this technique. This procedure uses a patch of the omentum to repair the injury because it is durable.

Is omental patch safe for duodenal perforation?

Conclusions: Omental patch is a safe and effective method of closure of duodenal perforations. Other procedures may be combined if high-risk factors are identified, e.g., large perforation size. The Jabalpur score is a simple tool in large emergency rooms with limited facilities.

What factors affect the outcome of omental patch repair for perforation?

Serum creatinine and size of perforation are factors linked to poor outcome. Omental patch repair is suitable for large perforations in the emergency setting with limited expertise; more data is needed to validate other techniques.

Is omental plugging better than omental patch reinforcement?

However, in several occasions with larger perforations the omental plugging seems a better choice to the omental patch reinforcement technique (omentopexy) (1, 34, 36, 37).