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Case Reports
. 2016 May 13;2016(5):rjw085.
doi: 10.1093/jscr/rjw085.

Intestinal perforation management using T-tube drainage

Tomoyuki Wakahara  1 , Masahide Kaji  2 , Yuko Harada  2 , Shinobu Tsuchida  2 , Akihiro Toyokawa  2
Affiliations
Case Reports

Intestinal perforation management using T-tube drainage

Tomoyuki Wakahara et al. J Surg Case Rep. .

Abstract

In cases of small bowel perforation with gross contamination, enterostomy has traditionally been the treatment of choice. An 86-year-old woman was diagnosed with perforative peritonitis. Emergency laparotomy revealed a small bowel perforation with gross contamination, and a T-tube enterostomy was performed. The T-tube was used for intestinal decompression for the first few days and was then accompanied by enteral feeding. When oral intake was sufficient, the T-tube was removed. The abdominal wall's fistula healed within 2 days of removal. Except for wound infection, the patient developed no postoperative complications. Under specific circumstances, a T-tube enterostomy can be an effective alternative for a traditional enterostomy. Its advantages include less or no anastomotic leakage, easier management of fluid and electrolyte levels, postoperative enteral feeding from the tube, a shorter operative time and no need for a second operation to close the stoma.

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Figures

Figure 1:
Figure 1:
(a) Perforation on the edematous and damaged small intestine wall. (b) A rubber T-tube was inserted through the perforation and tightened in place with several stitches. (c) The T-tube was brought out through the abdominal wall, and the bowel was sutured to the abdominal wall at the exit site.
Figure 2:
Figure 2:
The fistula closed spontaneously within 2 days.
See this image and copyright information in PMC

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