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Lesson learnt from a migrated drain: A case report
Veerabhadra Radhakrishna1, Sharad M Tanga2
1Department of Paediatric Surgery, Indira Gandhi Institute of Child Health, Bengaluru, India.
Introduction:
Though surgical drainage is used as a safety measure, it's not without complications. Migration of various drains has been described, but very little literature refers to the migration of peritoneal drain.
Presentation Of Case:
A 55-year male underwent anterior Gastro-Jejunostomy for inoperable metastatic carcinoma of the Gastric Pylorus. We found the peritoneal drain missing on the third post-operative day. On further evaluation, we found it to have migrated into the peritoneal cavity. We opened the operative wound for a partial length and retrieved the drain.
Discussion:
We did research to find why drain migrates and searched literature on migration of peritoneal drains. The possible etiologies for drain migration are (1) Drain hasn't been fixed properly (2) Cutting through of suture material (3) Relatively low abdominal pressure (4) Pressure over the drain by patient's body weight when he lies on the same side as drain.
Conclusion:
Every use of drain should be weighed for its needs and risks. Proper precautions during drain placement avoid unnecessary complications, morbidity and prolonged hospital stay.
Insights
Peritoneal drain migration is a rare complication. Proper fixation and placement are crucial to prevent this issue, reducing patient morbidity and hospital stays.
Area of Science:
- Surgical oncology
- Gastrointestinal surgery
- Medical device complications
Background:
- Surgical drains are essential safety measures but can lead to complications.
- Drain migration is documented for various types, yet peritoneal drain migration is sparsely reported in literature.
Observation:
- A case of a 55-year-old male following anterior Gastro-Jejunostomy for gastric pylorus cancer.
- The peritoneal drain was found missing on postoperative day 3 and subsequently located within the peritoneal cavity.
- The drain was successfully retrieved via surgical wound exploration.
Findings:
- Possible causes of peritoneal drain migration include improper fixation, suture material failure, low intra-abdominal pressure, and external pressure from body weight.
- These factors can contribute to the dislodgement and internal migration of the drain.
Implications:
- Careful consideration of drain necessity versus risks is paramount.
- Implementing proper drain placement techniques can mitigate complications, reduce patient morbidity, and shorten hospital stays.
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