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Surgery Small & Large Intestine 79917da0

A patient of Crohn's disease underwent resection anastomosis. Now present on 7th postoperative day with anastomotic leak from a fistula. Every day leakage volume adds up to 150-200 mL. There is no intra-abdominal collection and the patient is stable without any complaints. What will be next line of management?

A
Conservative treatment and leave him and hope for the spontaneous resolution
B
Perform laparotomy and check for leakage site and health margins
C
Perform laparotomy and completely exteriorize the fistula
D
Perform laparotomy and place drain and leave
High-Yield Explanation
Ans. (a) Conservative treatment and leave him and hope for the spontaneous resolutionRef: Sabiston 19th edition, Pages 1270-1272* As long as the patient has no signs of sepsis we can wait -- the waiting can be maximum for 4-6 weeks.* Only after 6 weeks we will plan for surgery: Excision of fistula and segmental resection of the involved bowel and reanastomosis.

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