Surgery>>>>>Colon, Rectum, and Anus
Question 11#

A previously healthy 46-year-old woman with a history of rectal adenocarcinoma, first discovered on colonoscopy 1 year ago who is status post low anterior resection with a diverting loop ileostomy returns to clinic 3 months after her low anterior resection for a preoperative appointment for her ileostomy reversal. Over the past 3 months she has had good ileostomy output as well as occasional loose stools per rectum. What workup does she need to have prior to ileostomy reversal?

A. A digital rectal examination to palpate the anastomosis and check for patency
B. No examination is needed as this was a simple diversion and she has continued to pass stool per rectum
C. A flexible sigmoidoscopy or contrast enema to check for patency
D. A colonoscopy to evaluate for polyps not previously seen on previous colonoscopy

Correct Answer is C

Comment:

A flexible endoscopic examination and a contrast enema (Gastrografin) are recommended prior to closure to ensure that the anastomosis has not leaked and is patent.