<prompt> A post-op pt. presents with peritonitis and massive contamination because of duodenal leak. Management of choice is -Four quadrant peritoneal lavageTotal parenteral nutritionDuodenojejunostomyDuodenostomy feeding jejunostomy  <response>: Duodenal leakage occurs through the stump that is left after operations for duodenal ulcer and gastric ulcer. Treatment 1 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. 2 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, 7the, p 468 