c l i n i c a l f o l i o s : n a r r a t i v e





A D V E R T I S E M E N T

 

Neoappendicostomy: 7

A D V E R T I S E M E N T

   
 

The neo appendicostomy is then folded back over the cecum in different configurations to determine which causes the least amount of angulation at the junction between the tube and the cecum. Care is taken not to overlap the two suture lines. A cecal wrap is then carried out by placing several non-absorbable sutures around the tube – 4-0 silk is a good choice. Proper function is tested by infusing normal saline to a pressure of 30 cm of water, removing the feeding tube and looking for leaks.     

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Neoappendicostomy: 8

A D V E R T I S E M E N T

   
 

The opening in the umbilicus is then created by everting the umbilicus and making a V-shaped incision, with the apex of the V at the deepest part of the umbilicus.       

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Neoappendicostomy: 9

A D V E R T I S E M E N T

   
 

The incision flap is turned back. 5-0 chromic sutures are placed in the four quadrants with the needles left on.       

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This page was last modified on 5/7/1999.