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Clin Colon Rectal Surg 2022; 35(03): 169-176
DOI: 10.1055/s-0041-1740043
Review Article

Management of the Hostile Abdomen

Megan Lundy
1   Division of Colorectal Surgery, Department of Surgery, Wake Forest University Baptist Health, Winston-Salem, North Carolina
,
Jean H. Ashburn
1   Division of Colorectal Surgery, Department of Surgery, Wake Forest University Baptist Health, Winston-Salem, North Carolina
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Abstract

Caring for a patient with a hostile abdomen is one of the most challenging clinical situations one can encounter. It requires specialized technical skill coupled with bold but thoughtful decision-making to achieve good outcomes. An approach to the patient with a complex, hostile abdomen must be individualized to account for the patient's personal details. However, implementing an experienced-based algorithm to help make the difficult decisions required in this setting can be helpful, as evidence-based studies are few. The purpose of this review is to provide a structured, evidence, and experienced-based approach to the challenges that the surgeon encounters when faced with a patient with a hostile abdomen, and to discuss perioperative and intraoperative surgical strategies that can lead to most successful outcomes.

Keywords

hostile abdomen - revisional abdominal surgery - enteric fistula - dense adhesions


Publication History

Article published online:
12 August 2022

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