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[Duodenal perforation due to an abdominal drain placed after appendectomy in a child

M Castagnetti1, M Cimador, E De Grazia

  • 1Department of Paediatric Surgery, Dipartimento Universitario Materno-Infantile, University of Palermo. marcocastagnetti@hotmail.com

La Pediatria Medica E Chirurgica : Medical and Surgical Pediatrics
|June 28, 2008
PubMed

Insights

Abdominal drainage after appendectomy is debated. A case of duodenal perforation from a drainage tube highlights risks, suggesting conservative management for bowel perforations without generalized peritonitis.

Area of Science:

  • Gastroenterology
  • Surgical Complications
  • Abdominal Surgery

Background:

  • The use of abdominal drainage after appendectomy, particularly for perforated appendicitis, remains a topic of clinical debate.
  • Standard surgical practice involves weighing the benefits of drainage against potential complications.

Observation:

  • A rare case of duodenal perforation was identified.
  • The perforation was caused by a silastic open drainage tube positioned in the right para-colic gutter.

Findings:

  • This event suggests that routine or liberal use of abdominal drains following appendectomy may carry significant risks.
  • The specific mechanism involved a drainage tube directly causing injury to the duodenum.

Implications:

  • The findings advocate for a more cautious approach to abdominal drainage after appendectomy.
  • Conservative management strategies should be considered for iatrogenic bowel perforations, especially when generalized peritonitis is absent.

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