Abstract
Various operative circumstances dictate temporary total diversion of the small intestine. Among these are severe peritonitis, multiple suture lines, fistulas, questionable vascular integrity, and an ileoanal anastomosis. The operative procedure is largely identical to creating a permanent Brooke ileostomy. The distal end of the intestine is closed and sutured in a side-to-side orientation to the proximal intestine just inside the peritoneal exit. A tube is left in the distal intestine for subsequent radiologic study. A major merit of this variation is the ease with which intestinal continuity can be restored. Because the two segments of intestine are tacked together, they are easily retrieved through a small circumstomal incision, and a side-to-side anastomosis can be constructed.
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