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Intestinal obstruction repair

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Illustrations

Intussusception - X-ray
Intussusception - X-ray
Before and after small intestine anastomosis
Before and after small intestine anastomosis

Alternative names    Return to top

Repair of volvulus; Reduction of intussusception

Definition    Return to top

Intestinal obstruction repair involves surgery to relieve a bowel obstruction. Complete intestinal obstruction, no matter what the cause, is a surgical emergency.

Description    Return to top

When a blockage occurs in the bowel (intestine), stool is unable to move through. Gas is trapped within the bowel, causing swelling and abdominal distention. The obstruction also causes restrictions of normal blood flow, which can cause portions of the bowel to die.

The inside of the bowel normally contains many bacteria that serve to help digest foods. When portions of the bowel die, the bowel wall can leak fluids and bacteria out into the abdominal cavity (peritoneum), causing a severe infection (peritonitis).

Intestinal obstruction can result from several causes, such as the following:

This procedure is performed while the patient is under general anesthesia (unconscious and pain-free). An incision is made in the abdomen. The site of bowel obstruction is located, the obstruction is relieved, and the bowel is examined for injury or ischemia (lack of blood flow leading to tissue death). Injured sections are removed and the healthy ends of the bowel are stitched together, if possible. If resection is not possible, the ends are brought out through an opening in the abdomen (ostomy).

Indications    Return to top

Surgery is necessary whenever an intestinal obstruction is present.

Intussusception has the highest incidence in infant boys between the ages of 4 and 8 months. Intestinal obstruction associated with intussusception is suspected if the child has experienced the following:

Abdominal X-rays are usually taken to confirm the diagnosis. A barium enema may be used for diagnosis and is sometimes successful in correcting the problem. If intussusception is diagnosed and not corrected by barium enema, surgery is necessary IMMEDIATELY to prevent complications such as gangrenous bowel and peritonitis.

Risks    Return to top

Risks for any anesthesia include the following: Risks for any surgery include the following: Other risks of abdominal surgery include the following:

Expectations after surgery    Return to top

The outcome is usually good if the obstruction is treated before tissue damage (ischemia) or tissue death (necrosis) occurs in the bowel.

Convalescence    Return to top

After surgery, vital signs are monitored and pain is treated. Recovery is quick in cases of a simple reduction and discharge may be within a week.

If a bowel resection was necessary, the patient will not be allowed to eat or drink for several days after surgery. Intravenous fluids, antibiotics, and a nasogastric tube (NG tube) may be needed.

If an ostomy was placed, the patient will need to learn how to care for and manage the ostomy bag. Future surgery will be needed to return the intestines to normal, and a longer hospital stay will be required.

Update Date: 11/19/2002

Updated by: Hebe Molmenti, M.D., Ph.D., Private Practice specializing in Plastic and Reconstructive Surgery, Baltimore, MD. Review provided by VeriMed Healthcare Network.

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