Enterotomy Essentials (Case)

Question

You have diagnosed a small intestinal foreign body and are planning on performing an enterotomy to relieve the obstruction.

 How do you plan to close the enterotomy site?

What technique will you use if you decide to resect a section of damaged small intestine?

Where is the most common site of leakage following enterectomy?

Answer

The suture holding layer must include the intestinal submucosa and most surgeons will select a monofilament absorbable suture material on a swaged on needle. Simple interrupted or continuous appositional techniques are ideal but an inverting pattern is used by some surgeons. Closure of enterectomy sites can be achieved with either simple continuous or interrupted appositional patterns.The most common site of leakage is at the mesenteric border due to the increased challenge to accurate suture placement in this location.