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6435 Surgery

A person underwent laparotomy for Crohn’s disease with melena. A 15 cm segment of ileum was found to be diseased. Segmental resection with healthy margins and end-to-end anastomosis was done. On 7th postoperative day, the patient developed anastomotic leak. He continued to have 150-200 ml fistula output for the next 7 days. There was no collection of fluid in the abdomen and now patient is stable. The ideal management is:

AContinue conservative management and expect the fistula to heal
BLaparotomy and revision of the fistula, if margins are healthy
CLaparotomy with dismantling of fistula and exteriorization
DLaparotomy and assessment. If lateral leak is present, only lavage and drainage
Surgery
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