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 bodiesDecision-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
- Complications
- Use of Antibiotics?
How to accommodate discrepancies in luminal size when performing a resection-anastomosis
- Increase spacing between suture bites on the larger diameter lumen compared to the smaller one. This is effective to treat small diameter discrepancies.
- Increase the luminal diameter of the smaller lumen by cutting the smaller lumen at a more acute angle than the larger lumen (always making the antimesenteric border shorter than the mesenteric border). This is effective to treat small diameter discrepancies.
- A small wedge of tissue can also be removed from the antimesenteric portion of the smaller diameter lumen creating a more oval opening that fits the larger diameter lumen. This can be used for moderate to large lumen discrepancies but in my experience is rarely necessary.
- Apposing the lumens evenly and closing the extra lumen as a cul-de-sac is not recommended.
< Video: Intestinal Resection and Anastomosis Decision-making in the management of gastrointestinal foreign bodies >