Distal ileal necrosis: right ileo-colic intussuscepted anastomosis as an alternative to ileostomy. 2014

J P Owono-Mbouengou, and D Ngabou, and D Folly, and M Essomo-Megnier-Mbo, and H Nyamatiengui, and R Nguema-Mve
Service de Chirurgie Viscérale de l'Hôpital d'Instruction des Armées Omar Bongo Ondimba, BP 20404, Libreville, Gabon. Electronic address: jpowono2@yahoo.fr.

BACKGROUND The technique of ileo-right colic intussuscepted anastomosis creating a neo-ileo-colic valve, was first described by Ribault in 1989 and has been shown to be of value in patients with typhoid ileal perforation as well as in other non-cancerous lesions of the terminal ileum. This technique is simple and rapid, and avoids ileostomy and/or ileo-cecal resection. The goal of this case-series was to describe the technique of ileo-right colic intussuscepted anastomosis as an alternative to ileostomy. METHODS This is a retrospective, monocenter study of patients with lesions of the terminal ileum who were managed with right ileo-colic intussuscepted anastomosis between January 2008 and December 2013. The technique was standardized. The main outcome criterion was the post-operative complication rate. RESULTS Four patients, three female and one male, with a median age of 35 years were managed with ileo-right colic intussuscepted anastomosis for necrosis of the terminal ileum. The cause of distal ileal necrosis was necrosis secondary to tubo-ovarian abscess and perforation secondary to non-specific ileitis, in one patient each, and band-related bowel obstruction with extended necrosis in two patients. There was no reported post-operative morbidity or mortality and, in particular, no post-operative anastomotic leak occurred. CONCLUSIONS Based on the findings in the literature and our series, right ileo-colic intussuscepted anastomosis is a simple technique, easy to learn and associated with little morbidity. These advantages underscore the need to be aware of this technique, which is particularly useful in countries where creation of an ileostomy is problematic.

UI MeSH Term Description Entries
D007077 Ileal Diseases Pathological development in the ILEUM including the ILEOCECAL VALVE. Disease, Ileal,Diseases, Ileal,Ileal Disease
D007079 Ileitis Inflammation of any segment of the ILEUM and the ILEOCECAL VALVE.
D007081 Ileostomy Surgical creation of an external opening into the ILEUM for fecal diversion or drainage. This replacement for the RECTUM is usually created in patients with severe INFLAMMATORY BOWEL DISEASES. Loop (continent) or tube (incontinent) procedures are most often employed. Loop Ileostomy,Tube Ileostomy,Continent Ileostomy,Incontinent Ileostomy,Continent Ileostomies,Ileostomies,Ileostomies, Continent,Ileostomies, Incontinent,Ileostomies, Loop,Ileostomies, Tube,Ileostomy, Continent,Ileostomy, Incontinent,Ileostomy, Loop,Ileostomy, Tube,Incontinent Ileostomies,Loop Ileostomies,Tube Ileostomies
D007082 Ileum The distal and narrowest portion of the SMALL INTESTINE, between the JEJUNUM and the ILEOCECAL VALVE of the LARGE INTESTINE.
D008297 Male Males
D009336 Necrosis The death of cells in an organ or tissue due to disease, injury or failure of the blood supply.
D003106 Colon The segment of LARGE INTESTINE between the CECUM and the RECTUM. It includes the ASCENDING COLON; the TRANSVERSE COLON; the DESCENDING COLON; and the SIGMOID COLON. Appendix Epiploica,Taenia Coli,Omental Appendices,Omental Appendix,Appendices, Omental,Appendix, Omental
D003125 Colostomy The surgical construction of an opening between the colon and the surface of the body. Colostomies
D005260 Female Females
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man

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