Multiple complications of postbulbar parapapillary ulcer combined with arteriomesenteric compression of the duodenum

Abstract

The article explores a clinical observation of a giant postbulbar parapapillary duodenal ulcer with multiple combined complications in the form of penetration into the pancreas, acute gastroduodenal bleeding and subcompensated stenosis occurred against the background of arterio-mesenteric compression of the duodenum in the subcompensation stage. The long course of the disease contributed to the development of alimentary dystrophy, cachexia and severe anemia. After stopping the bleeding, carrying out adequate preoperative preparation, the patient underwent Roux-en-Y gastric resection to “turn off” the ulcer with demucosation of the antrum and formation of the epipyloric stump of the duodenum according to the method modified in the clinic. The postoperative period was complicated by the development of a fistulous variant of duodenal stump suture failure, which was conservatively eliminated. The patient recovered.