<prompt> Duodenal blow out following Billroth gastrectomy most commonly occurs on which day ?2nd day4th day6th day12th day  <response>: Ans. is b i.e., 4th day Duodenal blow out is massive leakage from duodenal stump following Bilroth II gastrectomy. Clinical features: ? It usually occurs on 2nd to 7th postoperative days. In Bailey 22nde on page 689. it is specifically written that it occurs on 4th day. It usually presents as: ? - Sudden intense thoracoabdominal pain - Sudden elevation in pulse and temperature - General deterioration of condition Adequate drainage must be instituted immediately which is done by putting a catheter through an incision below the right costal margin. Total parenteral nutrition should be instituted and attention should be directed towards fluid and electrolyte therapy. Fistula closure can be anticipated within 2-3 weeks. 