RIVERA'S CONDOM AS A STRATEGY FOR MANAGING ABDOMINAL CATASTROPHIES. A CASE SERIES wjneumannordonez@gmail.com

PE069

RIVERA'S CONDOM AS A STRATEGY FOR MANAGING ABDOMINAL CATASTROPHIES. A CASE SERIES

6

Peru

Oral only

Catastrophic abdomen is one of the most complex and feared situations a trauma and emergency surgeon can face. Although it is not a common complication, its mortality rate is very high and its management is not systematically protocolized, so there is currently no single strategy for its successful resolution.

We present a series of four cases of open abdomen in which Rivera's condom was used as part of the management. All cases have in common the development of enteroatmospheric fistulas that were difficult to control. The mentioned technique was performed by the same operator in all cases. Some critical technical points to consider during the performance of the procedure are detailed, as well as the main difficulties faced and how they were overcome.

Ten critical points were considered, including the selection of suturing material and technique, latex thickness, distance between sutures, tissue thickness, and needle insertion direction at each point. Five main difficulties were identified, including the variable durability of the condom-bowel anastomosis, the adaptation of the condom to small-diameter fistulas without mucosal eversion, and the applicability of combining the technique with other strategies such as the VAC system.

Rivera's condom represents a versatile, practical, and low-cost strategy for the management of the hostile abdomen. A thorough understanding of the proposed critical points, which describe the technique in greater detail and provide troubleshooting strategies during its implementation, can be useful for perfecting and correctly performing the technique in centers with limited resources.