{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,7]],"date-time":"2026-08-07T16:08:15Z","timestamp":1786118895298,"version":"build-2736575974"},"reference-count":10,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"C","license":[{"start":{"date-parts":[[2024,12,1]],"date-time":"2024-12-01T00:00:00Z","timestamp":1733011200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2024,12,1]],"date-time":"2024-12-01T00:00:00Z","timestamp":1733011200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/legal\/tdmrep-license"},{"start":{"date-parts":[[2024,11,13]],"date-time":"2024-11-13T00:00:00Z","timestamp":1731456000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2024,12]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction:<\/jats:title>\n                    <jats:p>Gastroduodenal perforations are relatively common surgical emergencies with mortality rates as high as 40%. The Graham patch repair is one surgical approach but may need to be modified when the patient lacks viable omentum. The gastrocolic ligament can be utilized to repair these perforations for coverage.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Presentation of cases:<\/jats:title>\n                    <jats:p>Case 1: A 77-year-old female with a complex history presented with severe abdominal pain and was found to have pneumoperitoneum on CT scan. She was found to have a first segment duodenal perforation. We employed a modified Graham patch omentopexy utilizing the gastrocolic ligament to repair the defect. She recovered well with no complications.<\/jats:p>\n                    <jats:p>Case 2: A 65-year-old male with multiple myeloma presented with chemotherapy intolerance and diffuse abdominal pain. CT scan demonstrated pneumoperitoneum. Upon surgical exploration, he was noted to have a 1 cm anterior duodenal perforation. He had almost no viable omentum and therefore underwent a modified Graham patch repair using the gastrocolic ligament. He recovered well with no complications.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion:<\/jats:title>\n                    <jats:p>There have been reports of patients with gastroduodenal perforation with suboptimal omentum who underwent modified repair with the falciform ligament or a jejunal serosal patch repair. The gastrocolic ligament was found to be an effective alternative for our cases. This approach is an attractive one due to its relative ease and effectiveness.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>We described the use of the gastrocolic ligament as an alternative approach for gastroduodenal perforation in patients with suboptimal omentum. Further studies are needed to assess long term postoperative outcomes and establish best practices.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Highlights<\/jats:title>\n                  <\/jats:sec>","DOI":"10.1016\/j.ijscr.2024.110614","type":"journal-article","created":{"date-parts":[[2024,11,15]],"date-time":"2024-11-15T21:19:16Z","timestamp":1731705556000},"update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["Modification of the modified Graham patch repair for duodenal perforation using the gastrocolic ligament: Two case reports"],"prefix":"10.1097","volume":"125","author":[{"given":"Saamia","family":"Shaikh","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erica","family":"Kozorosky","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Megha","family":"Mehta","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Osama","family":"Elsawy","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"R1-132-20260423","doi-asserted-by":"crossref","DOI":"10.3389\/fsurg.2020.573901","article-title":"An overview of gastroduodenal perforation","volume":"7","author":"Weledji,","year":"2020","journal-title":"Front. Surg."},{"key":"R2-132-20260423","first-page":"235","article-title":"The treatment of perforated duodenal ulcers","volume":"64","author":"Graham,","year":"1937","journal-title":"Surg Gynecol Obstet"},{"issue":"5","key":"R3-132-20260423","doi-asserted-by":"crossref","first-page":"1136","DOI":"10.1097\/JS9.0000000000000373","article-title":"The SCARE 2023 guideline: updating consensus Surgical CAse REport (SCARE) guidelines","volume":"109","author":"Sohrabi,","year":"2023","journal-title":"Int. J. Surg. Lond. Engl."},{"issue":"6","key":"R4-132-20260423","doi-asserted-by":"crossref","first-page":"e161","DOI":"10.1097\/TA.0000000000002945","article-title":"A surgeon's history of the omentum: from omens to patches to immunity","volume":"89","author":"Bass,","year":"2020","journal-title":"J. Trauma Acute Care Surg."},{"issue":"1","key":"R5-132-20260423","doi-asserted-by":"crossref","first-page":"275","DOI":"10.1016\/S0039-6109(05)70406-0","article-title":"The greater omentum: anatomy, embryology, and surgical applications","volume":"80","author":"Libermann-Meffert,","year":"2000","journal-title":"Surg. Clin. N. Am."},{"issue":"12","key":"R6-132-20260423","doi-asserted-by":"crossref","first-page":"1385","DOI":"10.47191\/ijmscrs\/v2-i12-03","article-title":"Graham's patch repair for peptic perforation: a review","volume":"2","author":"Wandantyas,","year":"2022","journal-title":"Int. J. Med. Sci. Clin. Res. Stud."},{"key":"R7-132-20260423","doi-asserted-by":"crossref","first-page":"1209","DOI":"10.1001\/archsurg.1978.01370220095016","article-title":"Closure of an acute perforated peptic ulcer with the falciform ligament","volume":"113","author":"Fry,","year":"1978","journal-title":"Arch. Surg."},{"key":"R8-132-20260423","doi-asserted-by":"crossref","DOI":"10.1016\/j.amsu.2021.102477","article-title":"Outcomes of surgical management of peptic ulcer perforation using the falciform ligament: a cross-sectional study at a single centre in Vietnam","volume":"67","author":"Son,","year":"2021","journal-title":"Ann. Med. Surg."},{"key":"R9-132-20260423","doi-asserted-by":"crossref","first-page":"1382","DOI":"10.1002\/1097-0142(19930815)72:4<1382::AID-CNCR2820720438>3.0.CO;2-Y","article-title":"Spontaneous gastroduodenal perforation in patients with cancer receiving chemotherapy and steroids","volume":"72","author":"Liaw,","year":"1993","journal-title":"Cancer"},{"issue":"3","key":"R10-132-20260423","doi-asserted-by":"crossref","first-page":"549","DOI":"10.1023\/A:1018847126143","article-title":"Intestinal perforation. A common complication of scleroderma","volume":"42","author":"Ebert,","year":"1997","journal-title":"Dig. Dis. Sci."}],"container-title":["International Journal of Surgery Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S2210261224013956?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S2210261224013956?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.ovid.com\/10.1016\/j.ijscr.2024.110614","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,6]],"date-time":"2026-08-06T16:59:56Z","timestamp":1786035596000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.1016\/j.ijscr.2024.110614"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,12]]},"references-count":10,"journal-issue":{"issue":"C","published-print":{"date-parts":[[2024]]}},"URL":"https:\/\/doi.org\/10.1016\/j.ijscr.2024.110614","relation":{},"ISSN":["2210-2612"],"issn-type":[{"value":"2210-2612","type":"print"}],"subject":[],"published":{"date-parts":[[2024,12]]},"assertion":[{"value":"2024-09-23","name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-11-13","name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}}]}}