Endoscopic vacuum therapy in a patient without nasal access.

Abstract

Usually, upper gastrointestinal (GI) vacuum therapy is delivered through a nasal tube [1]. Herein we report a case in which this access route was not feasible. A 44-year-old man with a previous medical history of a T4aN2M0 extensive squamous-cell lip carcinoma, treated with neoadjuvant chemoradiotherapy followed by tumor resection (including rhinectomy) with surgical defect reconstruction 3 years before admission, was admitted owing to abdominal pain. Computed tomography showed a large pneumoperitoneum. The patient was submitted to an exploratory laparotomy, and a perforated duodenal ulcer was diagnosed and sutured.