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Reported Question / Answer
Q.) A 33 yrs pt presented with massive hemetemesis. A 2x2 cm ulcer was visualized on upper GI endoscopy on the posterior aspect of first part of duodenum.The Bleeding vessel was visualized but bleeding could not be controlled endoscopically. Blood transfusion was done and pt was planned for surgery.His BP was recorded as 90/70 and pulse rate was 110 with a Hb of 9 gm% at the time of surgery.The best surgical management is:
1)
Duodenotomy, with ligation of bleeding vessels with postoperative PPI
2)
Antrectomy with ligation of left gastric artery
3)
Duodenotomy, ligation of bleeding vessels, highly selective vagotomy
4)
Duodenotomy, ligation of bleeding vessels, truncal vagotomy and pyloroplasty
5)
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