This is a real-world medical entrance exam question, please give the true answer based on the question and selection. Topic name: Peritoneum, Subject name: Surgery
[{'content': 'A post-op patient presents with peritonitis and massive contamination because of duodenal leak. Management of choice is: \nSelect and explain. \nA. Four quadrant peritoneal lavage, B. Duodenostomy + Feeding jejunostomy + Peritoneal lavage, C. Total parenteral nutrition, D. Duodeno jejunostomy', 'role': 'user'}, {'content': "Answer: B \nExplanation: Ans. (b) Duodenostomy+ FJ + Peritoneal lavageDuodenal leak with massive contamination:* After some surgery probably Billroth 1 or Billroth 2 or perforation closure of Duodenal ulcer perforation there may be a leak from Duodenum.* The history clearly mentions the patient is having massive contamination.* Immediately shift the patient to Operation theatre with resuscitation and do emergency laparotomy.* Damage control surgery is done in massive Contamination- Thorough peritoneal lavage is done, Duodenal leak point is inserted with a Foley's catheter and brought outside (Duodenostomy) and always in such patients a feeding Jejunostomy is done to provide nutrition via enteral route* TPN will be needed only if the patient cannot tolerate Enteral nutrition", 'role': 'assistant'}]