The successful use of simple tube duodenostomy in large duodenal perforations from varied etiologies

Kutlu, Onur; Garcia, Steven

doi:10.1016/j.ijscr.2012.11.025

Cited by 28 publications

(22 citation statements)

References 39 publications

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“…Tube duodenostomy is a damage control procedure for large duodenal perforations when other repair techniques are not possible due to the magnitude of duodenal damage, hemodynamic instability of the patient or the lack of surgical expertise for complex reconstruction [64]. The perforation is sutured around a catheter inserted into the perforation to enhance directed fistulation of the perforation.…”

Section: Tube Duodenostomymentioning

confidence: 99%

Diagnosis and management of duodenal perforations: a narrative review

Ansari

Torén

Lindberg

et al. 2019

Scandinavian Journal of Gastroenterology

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Duodenal perforation is a rare, but potentially life-threatening injury. Multiple etiologies are associated with duodenal perforations such as peptic ulcer disease, iatrogenic causes and trauma. Computed tomography with intravenous and oral contrast is the most valuable imaging technique to identify duodenal perforation. In some cases, surgical exploration may be necessary for diagnosis. Specific treatment depends upon the nature of the disease process that caused the perforation, the timing, location and extent of the injury and the clinical condition of the patient. Conservative management seems to be feasible in stable patients with sealed perforations. Immediate surgery is required for patients presenting with peritonitis and/or intra-abdominal sepsis. Minimally invasive techniques are safe and effective alternatives to conventional open surgery in selected patients with duodenal perforations. Here we review the current literature on duodenal perforations and discuss the outcomes of different treatment strategies. ARTICLE HISTORY

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Section: Tube Duodenostomymentioning

confidence: 99%

Diagnosis and management of duodenal perforations: a narrative review

Ansari

Torén

Lindberg

et al. 2019

Scandinavian Journal of Gastroenterology

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“…In unstable patients, damage control principles with emphasis on hemostasis and containment of enteric contamination is the strategy. Tube duodenostomy alone [ 12 ] or triple tube decompression [ 13 ] are viable damage control procedures. In a stable patient with a complex DT, diversion procedures like pyloric exclusion and Berne’s duodenal diverticularisation [ 14 ] are used.…”

Section: Discussionmentioning

confidence: 99%

Primary reinforcement with rectus abdominis muscle flap-a salvage technique for a tenuous post traumatic duodenal perforation- a case report

Somasekar

Sankar

Krishna

2020

International Journal of Surgery Case Reports

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Highlights The travails in the management of complex duodenal injuries is well known among the surgical fraternity. We here present a salvage technique of primary reinforcement with pedicled rectus abdominis muscle flap (RAMF) for a tenuous post traumatic duodenal perforation (PTDP) of the second part. The majority of the studies in the literature are on the use RAMF for the repair of duodenal fistulas following failed primary repair of peptic perforations of first part of duodenum. Reinforcement with RAMF is a useful rescue technique when the omentum is not available and other simpler techniques are not feasible in the primary repair setting.

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“…Nobuaki and Kazuaki et al [18] performed the cholecystectomy and inserted the C tube through the cystic duct for biliary drainage, a retrograde duodenostomy and a feeding jejunostomy was done following duodenorrhaphy. Onur C et al [19] inserted Malecot catheter through the duodenal defect and secured it with purse string sutures along with decompressive gastrostomy and feeding jejunostomy. Furthermore, Stefano et al [20] did quadruple tube decompression.…”

Section: Discussionmentioning

confidence: 99%

Ten-Year Experience of Managing Giant Duodenal Ulcer Perforations with Triple Tube Ostomy at Tertiary Hospital of North India

et al. 2016

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Duodenal ulcer perforations have been known since 1600 AD. It is a common surgical emergency and every surgeon will encounter it. The perforation size of >2 cm has been used as the criteria for defining Giant duodenal ulcers. The management of giant duodenal perforations in hemodynamically unstable patient with comorbid condition is taxing because of high incidence of the postoperative leak and mortality. We have used the simple technique of Triple Tube Ostomy after the primary closure of the defect with encouraging results. It is a retrospective study done at the J. N medical college AMU Aligarh from May 2005 to May 2015. Hemodynamically unstable patients who have presented to the emergency with preoperative diagnoses of giant duodenal ulcer perforation and had undergone triple tube ostomy with primary repair of the perforation were included in the study. There were 34 patients of giant duodenal perforation who presented in shock. All of them underwent triple-tube-ostomy after primary repair of the duodenum. Thirty-two patients recovered with two mortalities (5.8 %). Several definite surgical techniques have been described for the management of giant duodenal ulcer perforation but they are complex, have very high morbidity and mortality rate and require an expert surgeon. A close retrospective scrutiny of the patients suggests that simple triple-tube-ostomy technique which is based on the principle of damage control surgery has good postoperative results Therefore, we recommend it as the procedure of choice in these patients.

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The successful use of simple tube duodenostomy in large duodenal perforations from varied etiologies

Abstract: Application of tube duodenostomy instead of a complex procedure in an unstable patient provides an opportunity to stabilize the patient, converting an impending catastrophe to a future scheduled surgery.

Cited by 28 publications

References 39 publications

Diagnosis and management of duodenal perforations: a narrative review

Diagnosis and management of duodenal perforations: a narrative review

Primary reinforcement with rectus abdominis muscle flap-a salvage technique for a tenuous post traumatic duodenal perforation- a case report

Ten-Year Experience of Managing Giant Duodenal Ulcer Perforations with Triple Tube Ostomy at Tertiary Hospital of North India

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