Double Gastric Peptic Perforation in a 61-Year-old Patient: A Case Report

Abstract

Introduction: Peptic ulcer perforation is one of the most frequent surgical emergencies, the major predisposing factor are Helicobacter pylori infection and NSAIDs chronic use, multiple simultaneous gastric perforations are extremely rare, and are described in literature in fragile patients. Presentation of the Case:  Our patient is a 61 year old male, with history of chronic smoking, admitted to the emergency room for generalized abdominal pain and vomiting, evolving for 5 days. CT scan showed multiple fluid collections with gas bubbles, the patient wa operated on with the discovery of 2 gastric perforations, one in the pylorus and the other in the antrum, primary suture was perfomed with omental patch and peritoneal lavage, the post operative course was uneventful and the patient was discharged on the fifth day. Discussion: peptic ulcer perforation is a frequent surgical emergency, however, double peptic perforation of the stomach is an extremely rare entity, its has been described few times in literature in patients with multiple risk factors. Conclusion: Double peptic perforation is a rare entity that should be known by surgeons in order to minimize complications and mortality.