External duodenal fistula following closure of duodenal perforation.

Simple item page
dc.contributor.authorVerma, G Ren_US
dc.contributor.authorKaman, Lileshwaren_US
dc.contributor.authorSingh, Gurpreeten_US
dc.contributor.authorSingh, Rajinderen_US
dc.contributor.authorBehera, Arunanshuen_US
dc.contributor.authorBose, Shashank Mohanen_US
dc.date.accessioned2006-01-29en_US
dc.date.accessioned2009-05-29T02:21:40Z
dc.date.available2006-01-29en_US
dc.date.available2009-05-29T02:21:40Z
dc.date.issued2006-01-29en_US
dc.description.abstractAIM: Retrospective analysis of experience with management of external duodenal fistula (EDF) without using total parenteral nutrition (TPN). METHOD: Medical records of 31 patients with EDF following closure of duodenal ulcer perforation, treated over a 7-year period (1994-2001), were studied. Twenty-one patients (68%) had evidence of sepsis at presentation or during the course of treatment. None could afford TPN for optimum time. All patients received hospital-based enteral nutrition through nasojejunal tube, besides supportive medical treatment and/or surgery. Peritonitis or failure to insert nasojejunal tube for enteric alimentation led to early surgery. RESULTS: Two patients died of septicemia and multi-organ failure within 48 hours of admission. Fourteen patients (48.3%) initially received conservative treatment (Group I); six of them later required surgery. Fifteen patients (51.7%) underwent early surgery due to peritonitis (n=9) or failure to establish enteral feeding (n=6) (Group II); wound infection, intra-abdominal abscess and septicemia were more common in these patients than those in Group I. Survival rate was higher in Group I than in Group II (86% versus 40%; p< 0.05). Septicemia and gastrectomy were the independent factors associated with high mortality. CONCLUSIONS: EDF can be satisfactorily managed without TPN. Successful placement of enteral feeding line, supportive treatment and delayed surgery can achieve survival in 85% of patients. Minimum intervention is recommended when early surgery is performed in peritonitis or to establish enteral feeding line.en_US
dc.description.affiliationDepartment of Surgery, Postgraduate Institute of Medical Education and Research, Chandigarh. grverma2004@yahoo.co.uken_US
dc.identifier.citationVerma GR, Kaman L, Singh G, Singh R, Behera A, Bose SM. External duodenal fistula following closure of duodenal perforation. Indian Journal of Gastroenterology. 2006 Jan-Feb; 25(1): 16-9en_US
dc.identifier.urihttps://imsear.searo.who.int/handle/123456789/64047
dc.language.isoengen_US
dc.source.urihttps://www.indianjgastro.comen_US
dc.subject.meshAdulten_US
dc.subject.meshAgeden_US
dc.subject.meshDuodenal Ulcer --surgeryen_US
dc.subject.meshFemaleen_US
dc.subject.meshHumansen_US
dc.subject.meshIntestinal Fistula --etiologyen_US
dc.subject.meshIntestinal Perforation --surgeryen_US
dc.subject.meshLogistic Modelsen_US
dc.subject.meshMaleen_US
dc.subject.meshMiddle Ageden_US
dc.subject.meshRetrospective Studiesen_US
dc.subject.meshSurvival Rateen_US
dc.subject.meshTreatment Outcomeen_US
dc.titleExternal duodenal fistula following closure of duodenal perforation.en_US
dc.typeJournal Articleen_US
Files
License bundle
Now showing 1 - 1 of 1
No Thumbnail Available
Name:
license.txt
Size:
1.79 KB
Format:
Plain Text
Description:
Download
Collections
Indian Journal of Gastroenterology