Well, one of the patients with a rectal perforation did very well and the other was doing very poorly. There was evidence of additional bowel leakage and I took her back to the OR. It’s always hardest to take your own patients back to the OR. Anyway, everything was plastered together. The bowels looked like a mass of ice cubes that had melted and refrozen together. After lots of careful dissection I found several interloop abscesses and a perforation of the distal small bowel. I resected that area and had to bring out a loop ileostomy. I also had to revise the prior colostomy.
Unfortunately there was so much swelling that I couldn’t close her abdomen and had to leave it open with a Bogata Bag or a laparostomy. I should be able to close her in about a week. Fortunately she’s doing much better since the 2nd operation.