Gastrointestinal System Disorders Q 316 - Gyan Darpan : Learning Portal
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Sunday, 10 April 2022

Gastrointestinal System Disorders Q 316

You’re doing preoperative teaching with Gertrude who has ulcerative colitis who needs surgery to create an ileoanal reservoir. Which information do you include?
    A. A reservoir is created that exits through the abdominal wall.
    B. A second surgery is required 12 months after the first surgery.
    C. A permanent ileostomy is created.
    D. The surgery occurs in two stages.

Correct Answer: D. The surgery occurs in two stages.

An ileoanal reservoir is created in two stages. The two surgeries are about 2 to 3 months apart. First, diseased intestines are removed and a temporary loop ileostomy is created. Second, the loop ileostomy is closed and stool goes to the reservoir and out through the anus. The ileoanal reservoir procedure is a surgical treatment option for chronic ulcerative colitis, colon cancer, and familial polyposis patients who need to have their large intestine (colon) removed. An ileoanal reservoir (or pouch) is an internal pouch formed of the small intestine.

Option A: The first surgery removes the entire large bowel and the lining of the rectum, but leaves the rectal muscle intact. A reservoir or “pouch” is made out of the small intestine and then is connected to the anus. In the initial weeks after surgery, waste material coming through the ileostomy is liquid but then begins to thicken. A good diet with increased fluid intake is needed to keep well hydrated and nourished.
Option B: Each patient considering this surgery is carefully evaluated to determine if this procedure is appropriate for them. This procedure is performed in one, two or three stages, but is most often done in two stages, usually 2-3 months apart.
Option C: Next, a temporary ileostomy is made. An ileostomy is a surgically created opening between the small bowel and the skin of the abdomen through which stool and gas are passed. This temporary ileostomy diverts the stool; protecting the reservoir (pouch)while it heals.

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