Question
A 75-year-old woman undergoes a right hemicolectomy and end ileostomy or right-sided perforated diverticulitis. What is the most concerning adverse outcome in the short term of this procedure and will require revision?
| A. |
Skin breakdown caused by succus entericus.
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| B. |
Stoma necrosis above the level of the fascia.
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| C. |
Stoma necrosis below the level of the fascia.
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| D. |
Stomal retraction below the level of the fascia.
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Show Answer
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Correct Answer � C
Explanation
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Answer C Stoma necrosis below the level of the fascia.
Stoma necrosis may occur in the early postoperative period and is usually caused by skeletonizing the distal small bowel and/or creating an overly tight fascial defect. Limited mucosal necrosis above the ascia may be treated expectantly, but necrosis below the level of the fascia requires surgical revision. Stoma retraction may occur early or late and may be exacerbated by obesity.
