Intestinal perforation management using T-tube drainage

Area of Science:

• Gastroenterology
• Surgical Innovation

Background:

• Traditional enterostomy is the standard treatment for small bowel perforation with gross contamination.
• Perforative peritonitis necessitates emergency surgical intervention.

Observation:

• An 86-year-old female patient with perforative peritonitis underwent emergency laparotomy for small bowel perforation with gross contamination.
• A T-tube enterostomy was performed, serving for intestinal decompression and subsequent enteral feeding.

Findings:

• The T-tube enterostomy allowed for effective intestinal decompression and facilitated early enteral feeding.
• The abdominal wall fistula healed rapidly after T-tube removal, with minimal postoperative complications apart from a wound infection.

Implications:

• T-tube enterostomy presents a viable alternative to traditional enterostomy in select cases of small bowel perforation.
• Advantages include reduced anastomotic leakage risk, simplified fluid management, integrated enteral feeding, shorter operative times, and avoidance of stoma closure surgery.