Chapter 11: Table of Contents
- 11.1 Intestinal Biopsy
- 11.2 Intestinal Biopsy Quiz
- 11.3 Intestinal Resection and Anastomosis
- Intestinal Apposition and Closure
- Suture the mesenteric rent, leak test, and omentalize
- Video: Intestinal Resection and Anastomosis
- How to accommodate discrepancies in luminal size when performing a resection-anastomosis
- Decision-making in the management of gastrointestinal foreign bodies
- Decision-making in the management of gastrointestinal foreign bodies: continued
- Decision-making in the management of gastrointestinal foreign bodies continued
- Enterotomy vs. Resection-Anastomosis
- Assessing Intestinal Viability
- Where to incise when removing a focal foreign body via enterotomy?
- Linear foreign body removal
- Where to cut when performing a resection-anastomosis
- Prognosis- foreign body
- Use of Antibiotics?
Decision-making in the management of gastrointestinal foreign bodies continued
Once the entire gastrointestinal tract has been assessed, a plan is made. If several incisions are required, begin with the least contaminated organ (stomach) followed by the more contaminated ones (duodenum, then proximal jejunum, etc.). Gentle handling of the affected loops of bowel is essential. Ischemic tissues are more fragile and excessive tissue trauma increases the risk of postoperative dehiscence. Protect exteriorized organs from dehydration by using moistened laparotomy sponges or towels. Isolate the exteriorized loop of intestine with moistened laparotomy sponges and temporarily release the tension on the Balfour retractor to somewhat close the abdominal cavity and reduce the risk of contamination. I sometimes pass the affected loop of bowel through a hole in the plastic wrap from the laparotomy sponge pack to isolate it even further.