TWO-STAGE SURGICAL TREATMENT OF ULCEROUS-NECROTIC ENTERITIS COMPLICATED BY PERFORATION AND GENERAL PERITONITIS IN A PATIENT WHO UNDERWENT TOTAL COLECTOMY

Abstract. The purpose of the message is to inform the medical community about a rare clinical observation – the case of ulcerous-necrotic enteritis complicated by peritonitis due to numerous bowel wall perforations in a patient who underwent total colectomy with application of ileorectal anastomosis for idiopathic megacolon more than 30 years ago. Materials and methods. The results of objective and instrumental methods of diagnosis, as well as the data of intraoperative findings were analyzed. The choice of surgical approach is based on the incisive analysis of the detected changes. Results and discussion. A serious problem was the impossibility of correct surgical elimination of the source of peritonitis during the first surgical intervention. Therefore, the decision on staged correction was taken. Conclusions: when it is not possible to perform a correct single-step surgical elimination of the source of peritonitis in case of ulcerous-necrotic enteritis, the surgical treatment should be carried out in incremental steps. Relaparotomy “at request” is an operation of choice. The decision on the timing of reintervention should be patient-specific.