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CROHN’S
ILEO-COLO-PROCTITIS
Toxic Mega-colon
Enterocolitis
uncertain etiology
Patient in need of
emergency surgical intervention
Indication
for surgical intervention
FAILURE OF
CONSERVATIVE TREATMENT-WITH
48 HOURS OF OBSERVATION
MAJOR
PRE OP CONCERNS
Severe toxaemia
Weight loss/ malnutrition
Anaemia
SEVERE DISEASE
Operative findings
Large gut wall- Inflamed,
Extremely friable from caecum to
rectum
Based on
PER OPERATIVE FINDINGS
HISTOPATH REPORT
Post- operative course
Wound sepsis
Burst abdomen
Continuous retrograde rectal discharge
Subphrenic abscess
Bil pleural effusion/pneumonia
Nutritional debilitation
Addiction to opeiods
MAJOR
POST OP PROBLEM
PROFUSE DISCHARGE
FROM RECTAL STUMP –
PERSISTENT RECTAL DISEASE
ANAL SPHINTEROTOMY
ANAL SUMP SUCTION
DRAINAGE
MULTIPLE
ENTEROCUTANEOUS
FISTULAE
2nd ADDED PROCEDURE
10th week post op
REMARKABLE RECOVARY
Weight gain, wound healing
ONGOING PROBLEM