Surgery for perforated duodenal ulcer -
Ans. is 'c' i.e., Omental patch repair Management of Peptic ulcer perforation* Nasogastric tube: whenever a perforated ulcer is suspected, the first step is to pass a nasogastric tube and empty the stomach to reduce further contamination of the peritoneal cavity.* Intravenous crystalloid: The patient is resuscitated aggressively by administration of intravenous crystalloid.* Intravenous broad-spectrum antibioticsSurgery:* Surgery is mostly indicated, although occasionally nonsurgical treatment can be used in stable patients without peritonitis, and in whom radiologic studies document a sealed perforation.* Surgery whether laparoscopy or laparotomy involves two components :i) Thorough peritoneal toilet# to remove all the fluid and food debris# drain is not indicatedii) Management of perforation# The most frequently performed operation for a perforated duodenal ulcer is simple closure with an omental onlay reinforcement or patch.# This is combined with postoperative H. pylori eradication (antibiotics + antisecretory agents)# Insertion of a nasoenteric or jejunal feeding tube should be considered
Vagotomy
Pyeloplasty
Omental patch repair
Roux-en-Y gastrectomy
Stomach & Duodenum