Vacuum Endoscopic Therapy for the Treatment of Perforated Gastric Ulcer: A Case Report and Literature Review

Author(s): Vanessa Costa Muniz, Willian Chaves, Adriano Silvério da Paixão, Ana Caroline C. da Silva, Bárbara Esteves Silva, Daniel Salerno Muzilli, Laís Yumi Takaoka, Lara Godela Delatore, Tauane de Lima Fiorillo

Vacuum endoscopic therapy (VET) has been widely studied and utilized as an innovative technique in the treatment of defects in the anterior intestinal wall. This therapeutic approach, based on creating a closed environment of negative pressure around the wound, has demonstrated promising clinical outcomes. Endoscopic use of negative pressure therapy was first described in 2004 and has since been applied in the treatment of anastomotic leaks, spontaneous perforations, and other gastrointestinal wall defects. Based on scientific evidence and favorable clinical results, VET has established itself as an important clinical tool, particularly in specialized centers in Europe. The technique promotes contraction, containment, cleaning, and healing of the infected wound area, with mechanisms of action that include collapse of the wound cavity, drainage of infected fluids, removal of debris and microorganisms, reduction of interstitial edema, and promotion of microcirculation. In the case of the perforated gastric ulcer described in this article, VET was successfully applied, resulting in significant clinical improvement and proper ulcer healing. The patient underwent wound area cleaning, application of vacuum dressing, and was kept on a nil per os (NPO) diet. After three days, there was improvement in symptoms and inflammatory parameters, and a follow-up esophagogastroduodenoscopy (EGD) confirmed improvement in the perforated area.

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