Early restoration of intestinal continuity in acute mesenteric ischaemia using Bishop-Koop stoma.

ABSTRACT

INTRODUCTION: Acute mesenteric ischaemia frequently requires extensive bowel resection. Primary anastomosis is unsafe necessitating exteriorisation of proximal small bowel and distal colon. Inevitably, therefore, patients are left with high output stomas with concomitant fluid and nutritional problems. SUBJECTS: We present two cases of acute mesenteric ischaemia both of which required extensive bowel resection. In both patients, we re-established intestinal continuity early by fashioning a Bishop-Koop type of reconstruction. RESULTS: Both patients had uneventful postoperative recoveries with no stoma-related complication or anastomosis problems. Neither patient required prolonged parenteral therapy. CONCLUSIONS: Bishop-Koop procedure may be used safely in a selected group of patients, with potential advantages of early restoration of intestinal continuity and easier closure.