Survival after colonic perforation during barium-enema examination. Modified radical surgical debridement
| Autor: | Thomas G. Hardy, Rene F. Hartmann, William R. C. Stewart, Pedro S. Aguilar |
|---|---|
| Rok vydání: | 1983 |
| Předmět: |
Adult
Male medicine.medical_specialty medicine.medical_treatment Perforation (oil well) Enema Peritonitis chemistry.chemical_compound Colonic Diseases medicine Humans Barium enema Aged Debridement Sigmoid Diseases business.industry Gastroenterology Sequela General Medicine medicine.disease digestive system diseases Colorectal surgery Modified radical Surgery Barium sulfate Pneumonia chemistry Intestinal Perforation Female Barium Sulfate business |
| Zdroj: | Diseases of the colon and rectum. 26(2) |
| ISSN: | 0012-3706 |
| Popis: | Four of five patients survived perforation of the colon incidental to barium-enema examination, while the other survived without sequela of infection until hemiplegia and pneumonia supervened two and 36 days, respectively, postoperatively. It is postulated that adequate intravenous fluids, early operation, with complete cleansing by antibiotic irrigation and mechanical debridement of the abdominal cavity, along with excision of the perforated segment of bowel with establishment of an end colostomy or ileostomy and distal mucous fistula, if possible, are keys to survival in these patients. Triple antibiotics, using ampicillin, gentamicin, and clindamycin, or metronidazole, should be administered in all patients as soon as the diagnosis is made, and continued postoperatively as indicated until there is no evidence of infection. An intraluminal intestinal tube, for stichless plication of the small bowel, may be helpful in some patients. A stomacone should be used for a barium enema through a colostomy stoma. Care should be exercised in performing barium contrast studies in patients with inflammatory bowel disease. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|
Full text from SpringerLink