Gastro-colonic anastomosis--a viable option in extensive small bowel infarction

Abstract

Introduction: We have previously presented a patient with massive small and large bowel infarction and demonstrated that even with only a few inches of remaining small bowel an almost normal life-style and diet is possible.

Patient: Recently, we have looked after a young and otherwise fit female patient who suffered mesenteric venous gangrene of the whole small bowel from the Ligament of Treitz to the caecum. In order to achieve gastro-intestinal continuity and to avoid the torrential fluid loss associated with high fistula, an anastomosis between the stomach and the transverse colon was formed.

Results: We are surprised to find that despite the extensive resection our patient maintains a good quality of life and is able to look after her young family.

Figure 1

Arteriogram demonstrating good flow in superior mesenteric artery following embolectomy but absent capillary blush consistent with mesenteric venous thrombosis.

Figure 2

Segment of resected ileum demonstrating typical appearance of venous gangrene.