Dear surgeons. I need your advice. I have a 60 years old female patient who had mesenteric ischemia of ileal segments compatible with thrombosis of Aa ileale of superior mesenteric arteria. I operated her last weekend as massive ileal resection and perform a bogota bag, terminal jejunostomy through the bogota and close the terminal ileum firstly. This was like a damage control surgery (as remnants only 100 cm jejunum+ 10 cm terminal ileum+whole colon intact). On postoperative 2. Day I took off the bogota and the remnant intestines look healthy and make a side to side jejunoileostomy anastomosis. I did not close the anterior fascia and only suture the skin. Now she is quite well in medical condition on postoperative 6.
Day. Only nasogastric amount is large as 1500 cc with bile fluid. Drain fluid is serous. Crp levels go lower day by day. What do you recommend in that patient for the following medical follow up? I mean the additional nutriotional/fluid administirations/oral intake etc
Best Regards