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Strictute sigmoid colon

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My mother has been diagnosed with a stricture of the sigmoid colon due to diverticulosis and has been told she requires a resection. The doctor feels that is will very likely be necessary to perform the procedure as a two part surgery. First the resection and a colostomy, within the next few days. Then a colostomy reversal about 8 weeks later. The reasoning for this is that her bowels are not clear since the stricture had made it difficult for her to pass stool and this would increase the chance for infection where the two portions of bowel are joined. We are apprehensive of a colostomy as that would require two major surgeries and the fact that she just had an ileostomy reversed in November. Her ileostomy was necessary because of a perforation she got after a hysterectomy, which was due to ovarian abscesses. We can't help but wonder if there is an alternative approach that would make it possible to do the resection in a single surgery. In addition to the diverticulosis it seems she may also have a rectovaginal fistula, as off and on she has been seeing what appears to be stool coming from her vagina.


Category: Gastroenterologist, Surgical

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Category: Gastroenterologist, Surgical
Dr. Lokesh HM is online now

Expert:  Dr. Lokesh HM replied 4 Days.

Hello,

Thank you for choosing DoctorSpring.

Sorry to hear about your mother's illness. I understand your concern.

I am of the opinion that the decision of two stage surgery is correct and carries low life risk, in view of obstructive diverticulitis stricture and presence of rectovaginal fistula.

But during first stage it had to be made sure that the stricture part and rectovaginal fistula part is well corrected.

Colostomy can be managed easily. .similar to ileostomy. ..as u you will be already knowing how to manage an ileostomy.

After the first surgery patient can expect good clinical improvement and hence the second surgery should uneventful.
Single stage surgery will carry high risk of leak from intestine joining site leading into infection and sepsis.
I strongly recommend two stage procedure for your patient.
All the best for surgery

Dr. LH

Hope this helps
Feel free to ask followups
Thank you


Dr. Lokesh HM
Category: Gastroenterologist, Surgical
Experience: 
Fellowship: Minimal Access Surgery (FMAS)
Fellowship: Pancreato-Biliary surgery (FPBS), SGPGI Lucknow, 2012
Senior Residency: MCh, Sanjay Gandhi Post Graduate Institute of Medical Sciences (SGPGI) Lucknow, 2011
Junior Residency: MS, PGIMER, Chandigarh, 2008
Medical School: MBBS, MS from Post Graduate Institute of Medical Education and Research (PGIMER) Chandigarh, 2007
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