This is a real-world medical entrance exam question, please give the true answer based on the question and selection. Topic name: None, Subject name: Surgery
[{'content': 'Which of the following is the management of choice in a patient presenting with peritonitis and massive contamination because of duodenal leak? \nSelect and explain. \nA. Four quadrant peritoneal lavage, B. Duodenostomy + feeding jejunostomy + Peritoneal lavage, C. Total parenteral nutrition, D. Duodenojejunostomy', 'role': 'user'}, {'content': 'Answer: C \nExplanation: Duodenal leakage occurs through the stump that is left after operations for duodenal ulcer and gastric ulcer. Treatment: Adequate drainage: It is achieved by inseion of large stump catheter through subcostal incision. This catheter is passed down to the duodenal stump area and a constant suction is applied. Total parenteral nutrition: Should be instituted and attention must be directed towards fluid and electrolyte therapy. This will lead to healing of fistula within 2-3 weeks. Ref: Schwaz 7/e, Page 468.', 'role': 'assistant'}]