Postoperative care

The patient returns to the ICU with a central venous catheter, possibly a pulmonary artery catheter, tracheal intubation, urethral catheter, gastrostomy, and appropriate drains in place. Fluid replacement, antibiotics, and inotropic agents are continued.

Classical teaching advocated that, regardless of clinical state, any patient who had undergone revascularization of the gut should be re-explored the following day because of the difficulty in assessing success at the first operation. Although this is true theoretically, it has now become apparent that, since surgeons have learned to avoid primary anastomoses, such operations are seldom required. An interesting modification is to introduce a wide-bore drain, through which a laparoscope can be introduced to inspect the bowel, at the time of the initial operation.

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