Graham patch

An appropriately-sized tongue of tension-free, well-vascularized omentum is used to plug the perforation. The omental patch is held in place by interrupted sutures placed through healthy duodenum on either side of the perforation. Once the patch is secure, the seal can be tested by submerging the site under irrigation fluid and injecting air into the patient's nasogastric tube. The absence of air bubbles indicates that the seal is intact.^[1]

• RR Graham, The treatment of perforated duodenal ulcers, Surg Gynec Obstet 64 (1937), pp. 235–238.

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