OPERATION: Laparotomy and Defunctioning Ileostomy
CEPOD: Emergency
ANAESTHETIC: General anaesthesia
INDICATION: Management of suspected anastomotic leak
INCISION: Through existing wound.
FINDINGS: Haemoserous fluid near anastomosis. No gross enteric contamination. No demonstrable anastomotic dehiscence on squeeze test.
PROCEDURE:
Anastomotic staple line oversewn and reinforced with PDS.
Loop ileostomy fashioned in right iliac fossa.
Washout with 2L normal saline.
Drains placed to pelvis.
CLOSURE:
1 PDS closure of external sheath using small-bite principles.
Clips to skin. Stoma matured with Vicryl.
POST-OPERATIVE INSTRUCTIONS:
HDU care. Nasogastric tube on free drainage overnight.
Continue antibiotics for at least 5 days.
Do not remove drains without consultant input.