La Van Phu, Tong Hai Duong, La Vinh Phuc, Le Thanh Nhat Minh, Tran Quan Minh, Dang Cong Phi, Doan Anh Vu
Department of Surgery, Can Tho City General Hospital, 04 Chau Van Liem Street, Tan An Ward, Ninh Kieu Disctrict, Can Tho 900000, Vietnam.
Faculty of Medicine, Can Tho University of Medicine and Pharmacy, 179 Nguyen Van Cu Street, An Khanh Ward, Ninh Kieu District, Can Tho 900000, Vietnam.
J Surg Case Rep. 2024 Dec 26;2025(1):rjae800. doi: 10.1093/jscr/rjae800. eCollection 2025 Jan.
Peptic ulcer perforations are common in surgical emergencies, whereas double perforations are rare, and triple peptic perforations are even exceedingly rare, with only a few cases documented. While undetected perforation during surgery can be fatal, the absence of standardized procedures for managing multiple perforations remains an ongoing challenge for surgeons. Herein, we describe a rare case of simultaneous triple peptic perforations in an elderly man with a prolonged history of analgesic and corticosteroid use. This case underscores the importance of screening multiple peptic perforations intraoperatively. Subtotal gastrectomy is suggested as an effective option when simple closure of perforations is infeasible.
消化性溃疡穿孔在外科急症中很常见,而双重穿孔很少见,三重消化性穿孔则极为罕见,仅有少数病例有记录。虽然手术中未被发现的穿孔可能是致命的,但缺乏处理多重穿孔的标准化程序对外科医生来说仍是一个持续的挑战。在此,我们描述了一例老年男性同时发生三重消化性穿孔的罕见病例,该患者有长期使用镇痛药和皮质类固醇的病史。这个病例强调了术中筛查多重消化性穿孔的重要性。当简单缝合穿孔不可行时,建议行胃大部切除术作为一种有效的选择。