Successful use of ligamentum teres hepatis for perforated duodenal ulcer following omentectomy: a case report

Our patient was a 59-year-old woman with past history of hysterectomy, bilateral salpingo-oophorectomy, regional lymphadenectomy and omentectomy performed for advanced ovarian cancer. She was experiencing abdominal pain over the past 2 days and visited our hospital owing to pain exacerbation. Contrast-enhanced computed tomography revealed free air around the liver, ascites and duodenal perforation; thus, emergent abdominal surgery was performed. The 5-mm duodenal perforation at the anterior wall of the duodenal bulb was sutured with absorbable thread. We used ligamentum teres hepatis (LTH) as a patch for the sutured site as the greater omentum could not be used. The postoperative course was uneventful, and shewas discharged on postoperative Day 8. Therewere no complications 1month after surgery. Although the greater omentum is conventionally used for upper gastrointestinal perforation, the LTH was a plausible alternative with good indication in our case.