ileal double-mouth fistula

The ileal double-mouth ostomy is a temporary incomplete enterostomy. Treatment of diseases: colonic rupture and intestinal obstruction Indication Strangulated intestinal obstruction, intestinal necrosis or traumatic intestinal rupture, severe shock, failure, can not tolerate one-stage resection, can be placed outside the intestine, after the patient's condition improved, the intestinal wall, abdominal wall between the mucosa, resection of the intestine It is a double-mouth enterostomy. Contraindications 1. The blood coagulation mechanism has serious obstacles. 2. Hypertension, diabetes, and some bleeding-prone diseases. Preoperative preparation Most patients are in poor condition and must be fully prepared before surgery. 1. Infusion, blood transfusion, correction of dehydration, acidosis and low plasma protein. 2. Intramuscular injection of vitamins b1, c, k. 3. Actively control infection and rational use of antibiotics. 4. Patients with intestinal obstruction or stomach or duodenal fistula should be placed with gastrointestinal decompression tube before operation. Surgical procedure 1. Position: supine position. 2. Incision: Right or left transabdominal rectus incision, depending on the location of the lesion. 3. External disease intestinal fistula: the intestinal fistula with lesions (necrosis, rupture, injury or infection) is gently presented to the abdominal cavity, placed outside the incision, the external part of the intestinal fistula should include the normal intestinal tube at both ends of the diseased intestinal fistula about 3cm, Warm saline gauze pad enclosure cover. The mesentery of the external intestinal fistula was sutured with the incision peritoneum. 4. Suture the abdominal wall: the peritoneum and the rectus abdominis sheath were sutured intermittently with a medium-sized silk thread, and the skin was sutured with a thin thread. The external intestinal fistula is wrapped around Vaseline gauze. 5. Treatment of external intestinal fistula: If the intestine is ruptured, the fistula can be placed through the fistula, and the intestinal wall can be sutured with a silk thread or a purse. If the intestinal tube is necrotic and the condition allows, the necrotic site can be removed. After resection, the fistula catheter is still placed in the intestinal lumen, sutured with a silk purse, the intestinal lumen is sealed, the intestinal lumen is decompressed, and the incision is prevented from being contaminated. The ostomy is covered with Vaseline gauze. If the condition is not good, the intestinal fistula may be temporarily placed in the incision, and the ostomy may be postponed. In order to enable the contents of the intestinal lumen to continue to enter the distal intestine, the intestine can be clamped between the intestines and the intestines after 4 to 5 days, so that the proximal and distal intestines are connected to each other after the intestinal tube is necrosis. complication The intestinal fluid leaks.