External ostomy for colon injury
Extracorporeal ostomy for colonic injury for surgical treatment of colonic injury. Colon injury is one of the more common intra-abdominal organ injuries, second only to small bowel injuries. Almost all colon injuries are secondary injuries to abdominal penetrating injuries. The blunt trauma of the colon only accounts for 3% to 5%, and the rectal injury accounts for less than 20% of the colorectal injury. Treating diseases: colon damage Indication The external ostomy of the colonic injury is applied to the transverse colon and the sigmoid colon. Preoperative preparation 1. Anti-shock: Colonic injury with shock, the mortality rate can be as high as 80%. Therefore, active and effective anti-shock in preoperative is of great significance in the treatment of colonic injuries. 2. The application of antibiotics: At present, it is recommended to use a combination of drugs, such as gentamicin and clindamycin, to start the drug before surgery, and continue to use 7 to 8 days after surgery. 3. Gastrointestinal decompression: can prevent postoperative flatulence. Surgical procedure 1. Because the transverse mesenteric membrane is longer, it is safer and more convenient to perform external treatment of the intestinal fistula. If the wound is small, it can be externally sutured. A glass tube is placed on the mesentery. 2. If the injury exceeds half of the circumference of the colon, or the damage of the mesenteric membrane seriously affects the blood circulation of the intestinal wall, the injured intestine segment should be removed, and a double-tube colostomy should be performed, or the distal and proximal ends of the colon should be pulled out of the stoma, respectively. I will fix it later. complication 1. The stoma is invaginated. 2. The small intestine is prolapsed. 3. Infection around the stoma.
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