Helical Tack Closure of a Failed Duodenal Perforation Repair

Introduction: Perforated duodenal ulcers often require emergency surgical intervention but are associated with up to a 9.8% failure rate.1–2 Endoscopic management is an option for the treatment of perforated duodenal ulcers in clinically stable patients and those who have ongoing leaks following initial operation. A variety of endoscopic options exist, including through and over-the-scope clips and endoscopic suturing devices.3 However, larger defects and difficult anatomical locations can create challenges for successful endoscopic repairs. Helical tacking systems are one management option that can be utilized for defects where repair with endoscopic clips and suturing devices may be difficult.4