Have you seen such a case before?

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On opening peritoneum gas equivalent to amount of gas created by pneumo peritoneum at Lap Chole escapes,hardly 500 cc of exudate escapes. At first glance all luminal structures appear normal.When stomach is separated from under surface of Liver.a 6-7 cm  transverse perforation comes into view, situated at body of stomach ,more towards lesser curvature,the margins,of perf are blackish,but bleed furiously on debridement.No definite growth is felt in the stomach.Pylorus is normal.A small patch,  3-4cm in diameter, of brownish blackish discolouration is seen at fundus but is not perforated,I debride and close the involved area ,do a peritoneal toilet,put wide drains and close.The debrided margins I sent for histology.
Will the Bx turn out to be NHL or Adenoca?Or there is a vascular explanation for this.Should I have done surgically any thing for the area of discoloration at fundus which I fear may give way and lead to gastrocutaneous fistula? Your inputs will be highly appreciated.
R.M.Khattar.
Delhi.


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