Management of leakage into the abdomen due to the involvement of jejunum in the incision line

Abstract

Here, we present the management of a patient, developing severe peritonitis due to laceration of the jejunum, involving sutures applied to facial layers after anterior resection for adenocarcinoma of the sigmoid colon. The patient, an 83-year woman, was operated by anterior resection, and relaparotomy was performed because the small bowel contents leaked from the incision. A compulsory stoma on the top of the incision was performed. Bilateral fasciocutaneous advancement flaps were carried out to treat the patient with severe intraabdominal sepsis via vacuum-assisted closure. The patient, with Apache-II score 12, open abdomen Bjorck score 2C, and Mannheim peritonitis index score 28, was monitored in the intensive care unit. Based on our experience, open abdomen management with vacuum-assisted closure might be successful for patients with intraabdominal sepsis because of uncontrollable primer sources. We propose that the technique defined for this patient is an innovative technique for primary source control of open abdomen patients.