Indications for anastomosis and intestinal stoma formation in patients with peritonitis and acute intestinal obstruction

V.I. Belokonev, A.I. Fedorin

SBE Institution «Samara State Medical University» MHSE of Russia

A retrospective analysis of 92 patients with acute intestinal obstruction and peritonitis, which were distributed on classifications V.N.Chernova, B.M.Belika (2002) and V.A.Koryachkina, V.I.Strashnova (2002) were performed. Resection of small intestine and hemicolectomy at different levels were indicated for 72 (78.3%) patients included in study. For 36 (39.1%) patients, who underwent emergency surgery the small –to small intestinal and small-to large intestinal anastomoses. In 52 (56.5%) patients after resection of small intestine, and after hemicolectomy - in 20 (21.6%) - were formed stoma.

Based on the analysis of treatment, it was found in reactive toxic stage forming anastomosis is possible, including patients with high cutting of small intestine (stoma formation is dangerous because loss of protein and electrolytes by intestinal chyme). In enteral insufficiency stage stoma forming is possible and the formation of intestinal anastomoses after decompression of the gastrointestinal tract. In stage of bacterial-toxic shock and multiple organ failure need to forming of intestinal stoma, because the formation of primary anastomosis is contraindicated.

Keywords: peritonitis, acute intestinal obstruction, small bowel stoma, anastomosis, enteral insufficiency.

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