Successful use of ligamentum teres hepatis for perforated duodenal ulcer following omentectomy: A case report

Abstract

Our patient was a 59-year-old woman with past history of hysterectomy, bilateral salpingo-oophorectomy, regional lymphadenectomy and omentectomy performed for advanced ovarian cancer. She was experiencing abdominal pain over the past 2 days and visited our hospital owing to pain exacerbation. Contrast-enhanced computed tomography revealed free air around the liver, ascites and duodenal perforation; thus, emergent abdominal surgery was performed. The 5-mm duodenal perforation at the anterior wall of the duodenal bulb was sutured with absorbable thread. We used ligamentum teres hepatis (LTH) as a patch for the sutured site as the greater omentum could not be used. The postoperative course was uneventful, and she was discharged on postoperative Day 8. There were no complications 1 month after surgery. Although the greater omentum is conventionally used for upper gastrointestinal perforation, the LTH was a plausible alternative with good indication in our case.