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?
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.
Conservative treatment and leave him and hope for the spontaneous resolution
Perform laparotomy and check for leakage site and health margins
Perform laparotomy and completely exteriorize the fistula
Perform laparotomy and place drain and leave
Small & Large Intestine