Abstract
BackgroundIntestinal failure (IF) is a rare but severe form of organ failure. The condition is defined as body’s inability to absorb adequate fluids, macronutrients and minerals for growth and development, so that intravenous supplementation is necessary. A broad spectrum of diseases, trauma and complications of surgery might eventually end up with intestinal failure. Nowadays, intestinal failure patients are preferably cared for in intestinal rehabilitation units (IRU). Autologous gastrointestinal reconstruction (AGIR) refers to non-transplant operative management of IF patients designed to improve enteral tolerance and gut absorptive capacity.Case presentationHerein we present five cases with complications of surgeries due to peptic ulcer bleeding, blunt abdominal trauma, obesity and gastric tumor. The surgeries were complicated by anastomotic leak, peritonitis and fistula formation. By adopting multidisciplinary decisions and special care for each complication, all the five patients were successfully managed and discharged.Discussion and conclusionsAs presented, re-anastomosis in presence of abdominal contamination will probably fail. In patients with intestinal failure, PN should start as soon as possible to increase the success rate of future surgeries and prevent potential need for intestinal transplantation. We suggest referring patients with complicated outcomes of gastrointestinal surgeries to the IRUs to reduce morbidity and mortality.
Highlights
Intestinal failure (IF) is a rare but severe form of organ failure
We suggest referring patients with complicated outcomes of gastrointestinal surgeries to the intestinal rehabilitation units (IRU) to reduce morbidity and mortality
Case 3 History and presentation A 40 year old lady had undergone hemigastrectomy and Billroth I operation with diagnosis of gastric neuroendocrine tumor (NET), few days later, due to anastomostic leak, the patient underwent a second laparotomy in which the surgeons took down the anastomosis, closed the duodenal stump and created a loop gastrojejunostomy (Bilroth II)
Summary
Re-anastomosis in presence of abdominal contamination will probably fail.
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