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The distal gastrocolic omentum was opened outside the gastroepiploic arcade to visualize the site of perforation. There was fibrinous exudates on the pre-pyloric posterior wall of the stomach, pylorus and posterior duodenal bulb. The omentum was gently peeled away to ensure there was no remaining free perforation. It appeared that the perforation had sealed and been walled off. Omentum was tacked over the area of prior perforation with 4-0 absorbable sutures. The patient was begun on h. pylori antibiotic treatment until the serology came back negative. She was also started on a proton pump inhibitor. She recovered uneventfully, and was scheduled for upper endoscopy 4 weeks after discharge to rule out neoplasm and confirm healing.
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