Gastric perforation repaired by hepatic round ligament: Case report and literature review.
Ribal Aby Hadeer, Angela Assaad, Hadi Farhat et al.
✦ AI-curated · Sources linked
Case in brief
A 44-year-old male with advanced gastric adenocarcinoma and peritoneal carcinomatosis presented with acute abdomen after stent insertion. Imaging confirmed gastric perforation and generalized peritonitis. During laparoscopic exploration, the omentum was unsuitable for repair due to carcinomatous infiltration, leading to the use of the hepatic round ligament as a patch to seal the perforation. The patient initially recovered but later succumbed to disease progression.
What made this case unusual
The use of the hepatic round ligament as a patch for gastric perforation repair in the context of advanced malignancy is an atypical approach, highlighting an alternative when conventional methods are not feasible.
Diagnostic / clinical pearl
Clinicians should consider the hepatic round ligament as a potential alternative for repairing gastric perforations in patients with advanced malignancies where omental repair is not possible.
Why it matters
This case underscores the need for innovative surgical techniques in challenging clinical scenarios, particularly in patients with complex abdominal pathology.