Attaur Rehman Khalil, Muhammad Yunas, Qutbe Alam Jan, Wagma Nisar, Muhammad Imran.
Grahm's omentopexy in closure of perforated duodenal ulcer.
J Med Sci May ;18(2):87-90.

Objectives: The aim of this study was to evaluate the effectiveness of Grahm’s Omentopexy in closure of perforated duodenal ulcer. Material and Methods: In this descriptive study, 98 patients were included who presented to Surgical Units of Khyber Teaching Hospital Peshawar and Medicare Hospital Peshawar from March 2006 to February 2009. Children and patients with Firearm injuries or history of Previous Surgery were excluded from the study. Results: Out of ninety eight patients, 81(82.65%) were male and 17 (17.34%) were female. Highest incidence was found in patients with > 41years age [46(46.90%) patients]. Twenty three (23.42%) patients reached hospital within 24 hours of developing symptoms while 51.02 % reached within 24-48 hours. Seventy eight (78.57%) patients presented with generalized abdominal pain and vomiting. Nearly 63% patients were having past history of peptic ulcer disease. Around 36.28% patients were smokers and 10.78% were using NSAIDS for various reasons. In 68.36% patients the size of Perforations was < 1cm. The patients were on nasogastric suction for 48 – 72 hours. In 80.65 % patients sips were allowed on third day. The infection rate was found to be 25.56%. Sixty three (63.26%) patients had uneventful recovery. Most of the patients (73.46%) were discharged on 6 th– 9 th day. Conclusion: Omentopexy (Grahm’s patch) is simple , safe and easy procedure which can save the life of patient by minimizing operative time , morbidity and mortality.

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