Medical MCQ - 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 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?

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

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Correct Answer:

Conservative treatment and leave him and hope for the spontaneous resolution

Description:

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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