{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,2]],"date-time":"2026-07-02T01:44:18Z","timestamp":1782956658047,"version":"3.54.5"},"reference-count":39,"publisher":null,"issue":"4","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2022,10]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Diagnosis of duodenal perforation (DP) in children is often delayed. This worsens the clinical condition and complicates simple closure.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives:<\/jats:title>\n                    <jats:p>To explore the advantages of using T-tube in surgeries for DP in children.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Patients and Methods:<\/jats:title>\n                    <jats:p>A retrospective study was conducted on all patients of DP managed in the Department of Paediatric surgery at a tertiary centre from January 2016 to December 2020. Clinical, operative and post-operative data were collected. Patients, with closure over a T-tube to ensure tension-free healing, were critically analysed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      A total of nine DP patients with ages ranging from 2 years to 9 years were managed. Five (55.6%) patients had blunt abdominal trauma; a 2-year-old male had perforation following accidental ingestion of lollypop-stick while a 3-year-old male had DP during endoscopic evaluation (iatrogenic) of bleeding duodenal ulcers; cause could not be found in other 2 (22.2%) patients. Of the five patients with blunt abdominal trauma, 4 (80%) had large perforation with oedematous bowel, necessitating repair over T-tube. Both patients with unknown causes had uneventful outcomes following primary repair with Graham's patch. Patients with lollypop-stick ingestion and iatrogenic perforation did well with repair over T-tube. The only trauma patient with primary repair leaked but subsequently had successful repair over a T-tube. One patient with complete transection of the third part of the duodenum and pancreatic injury who had repair over T-tube died due to secondary haemorrhage on the 10\n                      <jats:sup>th<\/jats:sup>\n                      post-operative day.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>Closure over a T-tube in DP, presenting late with oedematous bowel, ensures low pressure at the perforation site, forms a controlled fistula and promotes healing, thereby lessening post-operative complications.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.4103\/ajps.ajps_74_21","type":"journal-article","created":{"date-parts":[[2024,5,29]],"date-time":"2024-05-29T08:05:37Z","timestamp":1716969937000},"page":"217-222","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":2,"title":["Complicated Duodenal Perforation in Children"],"prefix":"10.67481","volume":"19","author":[{"given":"Rupesh","family":"Keshri","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Digamber","family":"Chaubey","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ramdhani","family":"Yadav","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vijayendra","family":"Kumar","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vinit Kumar","family":"Thakur","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rashmi","family":"Ranjana","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sandip Kumar","family":"Rahul","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":null,"reference":[{"key":"R1-5-20240829","doi-asserted-by":"crossref","first-page":"71","DOI":"10.1097\/MPG.0b013e31804069cc","article-title":"Perforated peptic ulcer in children: A 20-year experience","volume":"45","author":"Hua","year":"2007","journal-title":"J Pediatr Gastroenterol Nutr"},{"key":"R2-5-20240829","first-page":"28","article-title":"Perforation and haemorrhage duodenal bulbar ulcers in a child: A case report","volume":"53","author":"Ngom","year":"2008","journal-title":"Dakar Med"},{"key":"R3-5-20240829","doi-asserted-by":"crossref","first-page":"4853","DOI":"10.3748\/wjg.15.4853","article-title":"Perforated duodenal ulcer presenting with massive hematochezia in a 30-month-old child","volume":"15","author":"Lee","year":"2009","journal-title":"World J Gastroenterol"},{"key":"R4-5-20240829","doi-asserted-by":"crossref","first-page":"748","DOI":"10.1067\/msy.2002.127673","article-title":"Surgical management of duodenal injuries in children","volume":"132","author":"Ladd","year":"2002","journal-title":"Surgery"},{"key":"R6-5-20240829","doi-asserted-by":"crossref","first-page":"1679","DOI":"10.7863\/jum.2004.23.12.1679","article-title":"Sonographic diagnosis and monitoring of an obstructing duodenal hematoma after blunt trauma: Correlation with computed tomographic and surgical findings","volume":"23","author":"Megremis","year":"2004","journal-title":"J Ultrasound Med"},{"key":"R7-5-20240829","first-page":"235","article-title":"The treatment of perforated duodenal ulcer","volume":"64","author":"Graham","year":"1937","journal-title":"Surg Gynecol Obstet"},{"key":"R8-5-20240829","first-page":"14","article-title":"Giant perforations of duodenal ulcer","volume":"10","author":"Chaudhary","year":"1991","journal-title":"Indian J Gastroenterol"},{"key":"R9-5-20240829","doi-asserted-by":"crossref","first-page":"1616","DOI":"10.1007\/s00268-007-9114-3","article-title":"A life-saving but inadequately discussed procedure: Tube duodenostomy. 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