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.

Ernest Rehnke M.D., F.A.C.S.
1615 Pasadena Ave. So., Suite 460
St. Petersburg, FL 33707
727.344.0640 Office
727.344.0669 Fax

Don J. Schiller, M.D., F.A.C.S.
9808 Venice Blvd. # 603
Culver City, CA 90232
Ph: 310.204.4565
Fax: 310.204.4566
Email: drdjsmd@aol.com
Website: www.ileostomy-surgery.com
Location: West Los Angeles

Tillie Huber, R.N.
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

Susan Kay R.N.
Director, Speciality Surgical Services
Palms of Pasadena Hospital
1501 Pasadena Ave.
St. Petersburg, FL 33707
727.341.7706 or 1.800.336.0789

  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.)