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01-09-2015 | Technical Note

Different possible surgical managements of caustic ingestion: diagnostic laparoscopy for Zargar’s grade 3a lesions and a new technique of “Duodenal Damage Control” with “4-tubes ostomy” and duodenal wash-out as an option for extensive 3b lesions in unstable patients

Authors: Salomone Di Saverio, Andrea Biscardi, Alice Piccinini, Matteo Mandrioli, Gregorio Tugnoli

Published in: Updates in Surgery | Issue 3/2015

Abstract

In the present study, we have described two possible approaches in the management of caustic injuries. Diagnostic emergency laparoscopy can be used for exploration in case of stable patients with Zargar’s 3a gastric lesions and equivocal peritoneal signs. On the other hand, in case of patients with Zargar’s 3b gastric lesions with perforation, diffuse peritonitis and hemodynamic instability, a new possible technique is described as an option to be used in such extensive caustic injuries: duodenal damage control with “4-tubes ostomy” for duodenal and jejunal wash-out of the caustic agent. The aim of this simple technique is to wash-out the caustic agent from the duodenum when the duodenum and Treitz are not yet gangrenous/perforated, as well as to avoid duodenal primary closure and jejuno-jejunal anastomosis over damaged tissues.

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Title: Different possible surgical managements of caustic ingestion: diagnostic laparoscopy for Zargar’s grade 3a lesions and a new technique of “Duodenal Damage Control” with “4-tubes ostomy” and duodenal wash-out as an option for extensive 3b lesions in unstable patients
Authors: Salomone Di Saverio
Andrea Biscardi
Alice Piccinini
Matteo Mandrioli
Gregorio Tugnoli
Publication date: 01-09-2015
Publisher: Springer Milan
Published in: Updates in Surgery / Issue 3/2015
Print ISSN: 2038-131X
Electronic ISSN: 2038-3312
DOI: https://doi.org/10.1007/s13304-015-0313-4

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Different possible surgical managements of caustic ingestion: diagnostic laparoscopy for Zargar’s grade 3a lesions and a new technique of “Duodenal Damage Control” with “4-tubes ostomy” and duodenal wash-out as an option for extensive 3b lesions in unstable patients

Abstract

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Abstract

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