(384) Strategies for Prevention of POI

1. Minimizing surgical trauma of small intestine is a critical component to reducing risk of post-operative reflux. Which of the following surgical techniques is recommended?

A. Decompression of small intestine into the cecum

B. Decompression of small intestine through an enterotomy in the devitalized small intestine

C. Decompression of small intestine through an enterotomy in the proximal viable small intestine

D. Allowing decompression of the small intestine to occur naturally after resection of non-viable bowel

2. Surgical techniques that maximize the anastomotic luminal diameter are likely to reduce the risk of post-operative reflux. Which of the following suturing techniques is likely to produce the largest anastomotic diameter?

A. Simple continuous of mucosa followed by Cushing oversew

B. Continuous Lembert broken at mesenteric and antimesenteric locations

C. Single layer modified interrupted Lembert pattern

D. Full-thickness continuous following by Cushing oversew

3. Which of the following changes to packed cell volume (PCV) and total protein are most indicative of the development of post-operative ileus?

A. Decrease in PCV with no change or increase in TP

B. Decrease in PCV with concurrent decrease in TP

C. Increase in PCV with concurrent increase in TP

D. Increase in PCV with no change or decrease in TP

4. An elevation in which of the following post-operative blood parameters may contribute to a reduction in appetite:

A. Blood glucose

B. Triglycerides

C. Sodium

D. Creatine kinase

5. Gastric stasis may contribute to post-operative reflux development when a gastric impaction is identified concurrently with a surgical lesion. Which of the following is recommended to limit the potential for this post-operative complication?

A. Thorough and aggressive lavage and evacuation of stomach contents prior to surgery

B. Thorough and aggressive lavage and evacuation of stomach contents in the early post-op period

C. Use of intra-operative gastrotomy and removal of gastric contents

D. Use of intra-operative bypass procedure to allow for passive movement of fluid from stomach into small intestine

(384) Strategies for Prevention of POI

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