This Patient has a Continent Intestinal Reservoir (CIR) Continent Ileostomy

Intestinal Blockage/Obstruction

Symptoms: No output when a #30 Fr catheter is inserted into internal pouch, cramping abdominal discomfort with abdominal distention, nausea and vomiting, absent or faint bowel sounds.

  1. Emergency Room Nurse:Contact the patient’s CIR surgeon or local surgeon and obtain order for treatment.

Don J. Schiller, M.D., F.A.C.S.
5901 W Olympic Blvd, Ste 105
Ph: 323-472-9931
Fax: 323-939-4566
Email: drdjsmd@aol.com
Website: www.ileostomy-surgery.com
Location: Los Angeles, CA

Bernardo Colorado
Program Coordinator
Continent Ostomy Center
Olympia Medical Center
5900 W. Olympic Blvd
Los Angeles, CA 90036-4671
1.800.677.5252 Ostomy Line
323.900.7076 Hospital Ext 5448

  1. Administer pain medication as indicated.

  2. Begin IV fluids (Lactated Ringer’s/Normal Saline)

  3. Obtain abdominal X-rays to determine the site/cause of the obstruction.

  4. Insert a #30 Fr catheter into the internal pouch via the small stoma located in the lower abdomen. TAPE THE CATHETER to the skin at insertion site. IF USING A FOLEY CATHETER, DO NOT INFLATE THE BULB(Inflation of the bulb can place pressure on the tip of the valve causing sloughing of the valve.) Cut the bulb balloon at the catheter tip prior to insertion to prevent someone else from inflating the bulb.

  5. Connect the catheter to low intermittent suction.

  6. Irrigate the catheter using 30-60cc of Normal Saline every 2 hours (irrigation saline).

  7. Insert naso-gastric tube into the stomach and connect to low intermittent suction.

  8. Laboratory studies/test to evaluate fluid and electrolyte balance.

  9. Make patient NPO (Nothing by mouth.)