system
Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response.  Labels: BACKGROUND, METHODS, RESULTS. Meshes: Abdomen, Abscess, Adult, Aged, Anastomosis, Surgical, Anti-Bacterial Agents, Drug Therapy, Combination, Female, Humans, Intestinal Fistula, Jejunostomy, Length of Stay, Male, Middle Aged, Parenteral Nutrition, Postoperative Complications, Reoperation, Retrospective Studies, Sepsis, Suture Techniques, Sutures.
user
Is proximal loop jejunostomy a useful adjunct in the management of multiple intestinal suture lines in the septic abdomen? Context: Bowel repair in the septic abdomen can be problematic. This study investigated the use of a proximal loop jejunostomy to protect injured or fistulated bowel that had been returned to the abdomen after repair and/or anastomosis. Ten patients who underwent laparotomy for intra-abdominal sepsis and/or fistulation, followed by distal enteric repair and/or anastomosis and construction of a proximal defunctioning loop jejunostomy, were studied retrospectively. Seven patients had 21 intestinal suture lines returned to the peritoneal cavity in the presence of intra-abdominal sepsis (14 anastomoses, two enterotomy closures and five serotomy repairs). Two patients had a difficult relaparotomy for pelvic abscess (two distal anastomoses, one enterotomy closure and three serotomy repairs). The final patient had pelvic sepsis and radiation enteritis; the distal anastomosis was defunctioned by a loop jejunostomy. The median distance from the duodenojejunal flexure to the loop stoma was 80 (range 30-170) cm. All jejunostomies were closed via a local approach, a median of 11 (range 9-18) months after formation. There was no significant postoperative morbidity and no postoperative death. At a median follow-up of 7 (range 0.5-56) months eight patients had no requirement for nutritional support.
assistant
Use of a loop jejunostomy to protect suture lines in the septic abdomen justifies consideration of this procedure in selected patients. Final Decision: yes