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1.  Gastroduodeno-plasty performed by distal gastric transection.- A new technique for large duodenal defect closure 
Introduction
Duodenal ulcer lesions can represent a surgical challenge, especially if the duodenal wall is chronically inflamed, the defect exceeds a diameter of 3 cm and the ulceration is located in the second part of the duodenum.
Patient and method
We present the case of a 70-year-old male, who suffered from a 3 x 4 cm duodenal defect caused by duodenal pressure necrosis due to a 12.5 x 5.5 x 5 cm gallstone. Additionally, this stone caused intestinal obstruction (Bouveret’s syndrome) and bleeding with signs of shock. Besides the gallstone extraction, the common bile duct was drained by a T-tube and the duodenal defect closure was performed by a gastroduodeno-plasty and Bilroth II gastroenterostomy. The postoperative phase was uneventful. The reconstructed duodenum was endoscopically accessible and showed no pathological findings on follow-up.
Conclusion
The reconstruction of a large defect (> 3 cm) of the second part of the duodenum is safely feasible by a gastroduodeno-plasty. The critical gastroduodenal anastomosis can be protected by duodenal decompression, achieved by placing a T-tube in the common bile duct.
doi:10.1186/1750-1164-6-6
PMCID: PMC3432014  PMID: 22873823
Duodenal defect; Bouveret’s syndrome; Gastroduodeno-plasty
2.  Bipp 
British Medical Journal  1940;1(4126):191.
PMCID: PMC2176538
5.  TREATMENT OF MIDDLE-EAR SUPPURATION * 
British Medical Journal  1929;1(3561):643.
PMCID: PMC2450539  PMID: 20774597

Results 1-5 (5)