<prompt> A post-op patient presents with peritonitis and massive contamination because of duodenal leak. Management of choice is:Four quadrant peritoneal lavageDuodenostomy Feeding jejunostomy Peritoneal lavageTotal parenteral nutritionDuodeno jejunostomy  <response>: 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 Foleys 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 