Editing Large bowel obstruction (section)

== '''Operation''' ==

* If the large bowel is     severely distended and impeding view, decompress it with a 14G needle on a     syringe with the plunger removed, and attach to suction. Put that needle     through the tenia, ideally at a spot where you will make a hole anyway for     the anastomosis. If that fails due to fecal build-up, put a Poole sucker     through the hole.
* If in doubt, do an oncologic     resection
* If there is a large fixed     mass in the pelvis, don't try too hard to resect it
* Consider on-table colonic     lavage if doing an anastomosis, however UTD says not necessary
** Divide distally and place      the open distal end in a clean dish
** Pass a 16Fr Foley through      the base of appendix, run 4-6L of warm saline through until it comes out      clear, then close the appendicectomy