A Graham patch is a

surgical technique Surgery ''cheirourgikē'' (composed of χείρ, "hand", and ἔργον, "work"), via la, chirurgiae, meaning "hand work". is a medical specialty that uses operative manual and instrumental techniques on a person to investigate or treat a pat ...

that is used to close duodenal perforations. A piece of omentum is used to cover the perforation. This patch is typically used for holes with a size of 5mm or less.

Procedure

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 The duodenum is the first section of the small intestine in most higher vertebrates, including mammals, reptiles, and birds. In fish, the divisions of the small intestine are not as clear, and the terms anterior intestine or proximal intestine m ...

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 Nasogastric intubation is a medical process involving the insertion of a plastic tube (nasogastric tube or NG tube) through the nose, down the oesophagus, and down into the stomach. Orogastric intubation is a similar process involving the inserti ...

. The absence of air bubbles indicates that the seal is intact.

References

:* RR Graham, The treatment of perforated duodenal ulcers, Surg Gynec Obstet 64 (1937), pp. 235–238. Abdominal surgical procedures Digestive system surgery {{surgery-stub