Giant duodenal ulcer: a dangerous variant of a common illness.

Giant duodenal ulcers are large posterior penetrations of the duodenum which, when undiagnosed, have a high mortality. Radiographic and endoscopic diagnosis, although not always feasible, enables prompt appropriate management with improved results. Nonoperative treatment is dangerous. Preoperative diagnosis permits planned operative treatment and enables the surgeon to avoid a difficult duodenal dissection. The Bancroft operation, or modification thereof, is the operation of choice. Sixteen consecutive patients with giant duodenal ulcer are described. The success of their treatment is attributed to accurate diagnosis and appropriate operative therapy.