Fully Covered Self-Expandable Metal Stent Placement for Management of a Perforated Duodenal Ulcer With Persistent Leak in a Decompensated Cirrhotic.

Patients with cirrhosis have a high prevalence of peptic ulcer disease, which places them at increased risk for complications such as perforation. We report the case of a patient with decompensated cirrhosis who developed a duodenal ulcer perforation following an upper endoscopy for variceal screening. Due to poor surgical candidacy, he was managed conservatively through antibiotics, percutaneous drains, and endoscopic placement of a fully covered self-expandable metal stent (fcSEMS). With no established guidelines on managing duodenal perforations in cirrhotic patients, this case demonstrates a successful outcome with a nonoperative approach that can be considered when definitive surgical intervention is not feasible.