Right Hemi-Colectomy
SECTION 2.00 WORK UP
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2.01 FOR AN ELECTIVE PATIENT
A full clinical work up is needed. ie History, Examination,Sigmoidoscopy, Barium enema or colonoscopy and biopsy.
An IVU or Ultrasound scan will identify a possible obstructed kidney on the right and should confirm a normally secreting kidney on the left.
Hb + Full blood count, Urea and electrolytes.
ECG, Chest X-ray for lung metastases.
Special tests as needed for intercurrent diseases and past illness eg diabetes, cardiac disease respiratory disease.
Cross match 2 units of blood.
Transfuse preoperatively if the Hb is less than 9gm/dl. Ideally this should finish 3 days before the operation.
Bowel washout using soap enema 24 hours and 2 hours before the operation.
Shave from nipples to mid thighs.
Arrange a steroid programme if the patient has been taking steroids for more than 4 weeks.
2.01 FOR AN OBSTRUCTED PATIENT
In addition to the above procedures:
Resuscitate as necessary.
Correct fluid and electrolyte balance.