Once the clotting profile and anaemia had been stabilised by multiple transfusions of fresh frozen plasma (FFP), cryoprecipitate, packed red-blood cells (PRBC), platelets and Factor IX, a laparotomy was performed for duodenal atresia and for a duodenostomy when the baby was 4 weeks of age.
Various surgical techniques such as pedicled flap duodenal resection with end-to-end duodenostomy pyloric exclusion application of a synthetic mesh and jejunal serosal patching have been used to manage severe duodenal defects.35-10
Duodenal 'diverticulisation' is the most radical of these procedures with primary closure of the duodenal wound, a vagotomy, an antrectomy with an end-to-side gastrojejunostomy, T-tube common bile duct drainage, and a tube duodenostomy. There is no evidence that this approach is necessary, and it is now of historical interest only.
16 46/F Pancreatic cancer with liver metastasis, perforated gastric ulcer status post primary closure and duodenostomy, gastrostomy and jejunostomy, poor control of diabetes mellitus and hypertension, glaucoma.