This is a real-world medical entrance exam question, please give the true answer based on the question and selection. Topic name: Stomach & Duodenum, Subject name: Surgery
[{'content': 'Surgery for perforated duodenal ulcer - \nSelect and explain. \nA. Vagotomy, B. Pyeloplasty, C. Omental patch repair, D. Roux-en-Y gastrectomy', 'role': 'user'}, {'content': "Answer: C \nExplanation: Ans. is 'c' i.e., Omental patch repair Management of Peptic ulcer perforation* Nasogastric tube: whenever a perforated ulcer is suspected, the first step is to pass a nasogastric tube and empty the stomach to reduce further contamination of the peritoneal cavity.* Intravenous crystalloid: The patient is resuscitated aggressively by administration of intravenous crystalloid.* Intravenous broad-spectrum antibioticsSurgery:* Surgery is mostly indicated, although occasionally nonsurgical treatment can be used in stable patients without peritonitis, and in whom radiologic studies document a sealed perforation.* Surgery whether laparoscopy or laparotomy involves two components :i) Thorough peritoneal toilet# to remove all the fluid and food debris# drain is not indicatedii) Management of perforation# The most frequently performed operation for a perforated duodenal ulcer is simple closure with an omental onlay reinforcement or patch.# This is combined with postoperative H. pylori eradication (antibiotics + antisecretory agents)# Insertion of a nasoenteric or jejunal feeding tube should be considered", 'role': 'assistant'}]