Surgical Management of Duodenal Perforation in a Patient With Gardner Syndrome and Abdominal Wall Reconstruction

Abstract

Duodenal perforation is a rare complication of esophagogastroduodenoscopy (EGD) and may be caused by direct injury from the endoscope during the procedure. This complication has a relatively high mortality rate but can be reliably managed with surgical repair. We present the case of a young man with Gardner syndrome who obtained a duodenal perforation during a surveillance EGD with endoscopic mucosal resection (EMR). Our patient was deemed a poor surgical candidate due to previous excision of a large abdominal wall desmoid tumor with cadaveric graft reconstruction that in turn created limited access for any subsequent abdominal surgeries. As such, he underwent multiple failed endoscopic repairs before definitive surgical management with a Graham patch repair using a unique entry approach. This case highlights the treatment course of this rare patient.

J Curr Surg. 2021;11(3):61-64
doi: https://doi.org/10.14740/jcs443