Foley catheter enterostomy for postoperative bowel perforation: an effective source control

Area of Science:

• Gastroenterology
• Surgical Innovation
• Abdominal Surgery

Background:

• Postoperative bowel perforation necessitates control of bowel effluents, typically achieved via stoma formation.
• When stoma creation is not possible, surgeons face limited alternatives for managing leaks.
• This report details the use of Foley catheter enterostomy for source control in complex bowel perforation cases.

Observation:

• A Foley catheter enterostomy was constructed at the leak site in three patients with postoperative bowel perforations.
• The catheter balloon was inflated with saline, and the bowel segment was secured to the abdominal wall.
• Gentle traction was applied to the catheter via external sutures.

Findings:

• Immediate control of bowel leakage was achieved in all three patients.
• Two patients tolerated early enteral feeding, with catheter removal between 17-28 days.
• Drainage from the catheter sites ceased within two days.

Implications:

• Foley catheter enterostomy presents a safe and effective method for managing postoperative bowel perforations when stomas are not an option.
• The technique allows for prompt source control and supports early initiation of enteral nutrition.
• Limitations include large defects, compromised bowel wall integrity, and inability to mobilize the bowel segment without tension.