Question:hard
A 6-year-old boy developed life-threatening shock; his CT scan showed a large amount of ascites, bowel wall thickening, and poor or absent enhancement of a strangulated bowel segment. Surgical exploration revealed gangrenous bowel. Which of the following is TRUE about the bowel anastomosis?
A 6-year-old boy developed life-threatening shock; his CT scan showed a large amount of ascites, bowel wall thickening, and poor or absent enhancement of a strangulated bowel segment. Surgical exploration revealed gangrenous bowel. Which of the following is TRUE about the bowel anastomosis?
Show Hint
Inverting suture that does not enter the bowel lumen.
Updated On: Jun 24, 2026
- It should be done in continuous layers as it takes less time
- It should be done with catgut
- It should be done by single-layer seromuscular Lembert sutures
- It should be done by a single layer taking the submucosa
Show Solution
The Correct Option is C
Solution and Explanation
Step 1: Recognize the diagnosis: an internal (transmesenteric) hernia has strangulated the small bowel, producing gangrene that must be resected and the ends rejoined.
Step 2: The favoured anastomotic method here is a single-layer technique using seromuscular Lembert sutures.
Step 3: The Lembert suture is an inverting stitch that approximates the serosa and muscularis without piercing the lumen, keeping the join clean; it may be placed continuous or interrupted.
Step 4: Choosing continuous closure merely for speed, using catgut, or a single layer that grabs the submucosa do not represent the recommended seromuscular Lembert approach. Hence the correct statement is the single-layer seromuscular Lembert anastomosis.
\[\boxed{\text{Single-layer seromuscular Lembert sutures}}\]
Step 2: The favoured anastomotic method here is a single-layer technique using seromuscular Lembert sutures.
Step 3: The Lembert suture is an inverting stitch that approximates the serosa and muscularis without piercing the lumen, keeping the join clean; it may be placed continuous or interrupted.
Step 4: Choosing continuous closure merely for speed, using catgut, or a single layer that grabs the submucosa do not represent the recommended seromuscular Lembert approach. Hence the correct statement is the single-layer seromuscular Lembert anastomosis.
\[\boxed{\text{Single-layer seromuscular Lembert sutures}}\]
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