A 6-year-old boy experienced life threatening shock ,his CT scan showed large amount of ascites, bowel wall thickening and poor or absent enhancement of the strangulated bowel segment, showing gangrenous bowel on surgical exploration.True about anastomosis is-
High-Yield Explanation
* Diagnosis is of congenital IH with strangulated small bowel with gangrenous small bowel * Transmesenteric hernia was the most common type in older children as well as in neonates . * IH results from incomplete closure of surgically created mesenteric defects, and usually acquired resulting from previous abdominal surgery especially Roux-en-Y anastomosis * Anastomosis should be done by single layer seromuscular lembe sutures * The Lambe suture generally is used in abdominal surgery. It is an inveing suture, that can be either continuous or interrupted, used to join two segments of an intestine without entering the lumen (the inner channel through which stomach contents flow). REF : BAILEY AND LOVE 27TH ED