If the mucosa was accidentally opened at operation (Ramstedt) it is wise not to feed the child orally for -
Ans. is 'b' i.e., 24 Hours Maingot's writes - "The overlying duodenal mucosa is firmly adherent to the muscle layer and is torn easily if the splitting procedure is carried too far distally. A duodenal perforation is not a catastrophe unless it remains unrecognized. Injecting air into the stomach and squeezing it through into the duodenum will make a perforation of the duodenum obvious. Any such perforation should be closed by direct suture with Dacron. The defect may be closed with a patch of omentum, but because this structure is relatively underdeveloped in the young infant, insufficient omentum may be available for this procedure". About postop care Maingot writes "The nasogastric tube may be removed soon after the infant has recovered from the anaesthetic. However, if perforation has occurred, nasogastric decompression is required for 24 hrs." Also remember Feeding is staed as early as 4 hrs after an uncomplicated Ramsted operation.
12 Hours
24 Hours
48 Hours
1 week