Bypass Revision - JP Drain Complication

[silvergirl404]

I had a VBG to RNY done 9/10/12.  A week later I almost died while vomiting profuse amounts of blood.  I had a scope after being stabilized in the hospital.  They found that the JP drain had traveled into the staple line of my new pouch/intestines junction. The doctor elected not to do surgery.  He said he would back the drain out slowly to allow the tissues to seal themselves.  I still have a hole in my stomach causing my liquids (which is all I can eat) to come out the drain hole.  They have cut the bulb off and just a little piece of it remains being held in place outside my body by a safety pin.  Any advice could save my life.  I am scared that I'm not doing the right thing in trusting that this surgeon knows what he is doing.  

My original VBG was done in '92.  

[silvergirl404]

Back almost to square one.  I had a scope with attempted stent placement two days ago.  The JP drain tube is still in my stomach!  All of the tests, CT scan, UGI showed that it was not.  They couldn't place the stent because of swelling and the TUBE.  Seriously, I've had the tube backed out three times, how long is this thing?  Wondering why they haven't done an MRI?  I still have a safety pin attached to my stitches around the drain hole holding the tube in place.  A staple actually came out of the drain onto my dressing.  Any thoughts?

[toni6810]

this is not really a stomach question but i am trying to get some answers on how  a person can actully die from having a jp drain out. my husband had NO signs of cancer and was ready to go home with discharge papers and only thing that need to come out was the drain. the resident pulled out the drain which caused my husband extrem amount of pain.  i have had many and none of them caused me that much pain. after reviewing his medical records and fining out that when they dictated what hs happened they maid it sound like he had cancer in his body but after 5 family memebers  were tol verbly by the doctor that she has removed all the cancer and the drain tht the resient pulled out caused a hole and well since then he was not doing very well.   why does one not listen to the patient!? the drain caused a hole in his reconstructive esophagus and the resident was not there to be found the next time my husband came back the resident was gone and the dictation on the records is wrong and no one will help me. any one have any advise on what i should do. he passed unexpectantly due to the drain causing a whole.

[silvergirl404]

CT Scan yesterday showed the end of the tube was in the proper place -- outside the stomach.  Incredible pain brought me to the ER.  The CT scan was probably the most painful thing I have ever endured since the positioning broke up the "track" that my tissues had created -- this caused a bit of bleeding out the drain.  I cried through the whole thing.  

Finally the situation was explained to me.  I have fluid in one lung which I suspected due to being unable to inflate my lung completely due to the pain on my left side.  

Infection was finally treated with IV antibiotics and oral antibiotics to take home (augmentin).  I'm relieved but near the end of the doctor's talk with us I had one more question (how do i clean the area properly).  I asked if I could ask this one more and he said, "no, I have other patients-you have already had a good deal of my time" to paraphrase.  

I don't understand this.  But nonetheless, I was released and relieved.  

[silvergirl404]

The condition has improved in that most everything goes through normally.  I have normal bowel movements and urine output.  The only thing that seems to leak through is chicken broth at this point.  I am avoiding it so this seems promising.  Early on I could see colors on the gauze of fruit juices etc. that I was consuming.  This has stopped so it's a good sign that the hole is closing/closed.  

I appreciate your comments very much.  Thanks for taking the time to respond to my question.  

[Christopher R Watters, MD]

Make sure I understand your situation. Does everything that you consume come out the drain or are you eating but some drainage is still present? If everything comes out how are you being supported nutritionally?

If food is travelling past the area of drain erosion slow removal is probably the wisest thing to do. If everything is coming out the drain even when not on suction then a revision would most likely be required. To answer your question, I have seen JP drains erode into stomach, small intestine, and colon. In all these circumstances, slow removal over multiple weeks has allowed for the avoidance of further surgery.

[Joolsa]

I don't know where you are but I would find a doctor that treats bypass problems. My friend lost her hair, her teeth & has suffered greatly after her bypass. Her doctor is at UCLA & has saved her life. Find one that repairs bypass blunders, not the same doctor that caused it in the first place.

[silvergirl404]

I appreciate your response more than you know.  Have you heard of this complication before?  I've found zero info online about the end of a drain piercing the staple line.  Any causes you can think of?  

[Christopher R Watters, MD]

What he is saying is sound. It is probably the best way to salvage the situation.