A 25 yrs old male underwent laparotomy for internal hernia 4 mths back, intra op it appeared to be like whole small bowel was encased in a coon,or sac.Terminal ileum was gangreneous, and dense adhesions were their between small bowel loops, patient underwent end to side ileo asending anastamosis with diversion stoma ileostomy since bowel was very oedematous, work up for kochs was negative( TB Polymerase Chain Reaction, Montoux, sedimentation rate, adenosine deaminase). No anti kochs treatment was given, after 14 wks loopogram done, which showed no leak and contrast was seen in rectosigmoid and rectum, pt was planned for ileostomy revarsal.
Ileostomy reversal was done, ( did resection anastamosis) , since post op day 1 pt started passing flatus and mucoid bile stained stools, ryles tube drainage was nil, started on sips orally on post op day 6,V tolerated for 24 hrs, then had vomitting…
