Three cases report of gastrointestinal leaks after gastric suturing treated with self-made water-drip negative-pressure dual-lumen tube combined with enteral nutrition.

RATIONALE: Postoperative gastrointestinal leaks complicated by severe intra-abdominal infection remain a significant clinical challenge. This report describes a conservative management approach using a self-made, water-drip, negative-pressure, double-lumen tube combined with enteral nutrition in three cases, highlighting its potential as a technical option when immediate surgical closure is not feasible.

PATIENT CONCERNS: Three patients developed gastrointestinal leaks with severe intra-abdominal infection following gastric suturing. They presented with signs of peritonitis, sepsis, and persistent drainage from surgical sites.

DIAGNOSES: Gastrointestinal leaks were confirmed postoperatively by imaging studies (e.g., contrast-enhanced computed tomography or fistulography) and clinical manifestations of severe intra-abdominal infection.

INTERVENTIONS: A self-made, water-drip, negative-pressure, double-lumen tube was placed percutaneously for active irrigation and drainage of the infected cavity, combined with enteral nutritional support to maintain metabolic needs and promote healing.

OUTCOMES: Two patients achieved full recovery and were discharged. The third patient showed significant clinical improvement and was transferred to a local hospital for continued care, where they eventually recovered and were discharged.

LESSONS: For complex postoperative gastric leaks unsuitable for immediate definitive closure due to poor tissue quality and severe infection, percutaneous active irrigation and drainage using a self-made, water-drip, negative-pressure, double-lumen tube can be a valuable technical option within a multidisciplinary comprehensive management strategy. This approach may help control infection and facilitate healing while avoiding high-risk reoperation.