Intestinal obstruction repair

Definition

Intestinal obstruction repair is surgery to relieve a bowel obstruction (blockage). A complete obstruction is a surgical emergency, no matter what the cause is.

Alternative Names

Repair of volvulus; Reduction of intussusception, lysis of intestinal adhesions

Description

Intestinal obstruction repair is done while you are under general anesthesia. This makes you unconscious and unable to feel pain.

The surgeon makes an incision (cut) in your belly to expose your intestines. Then the surgeon locates the area of your intestine (also called "bowel") that is blocked. The blockage will be freed. Any injured sections of your bowel will be repaired or removed. If a section is removed, the healthy ends will be reconnected with stitches.

See also: Large bowel resection

Sometimes when part of the intestine is removed, the ends cannot be reconnected. If this happens, the surgeon will bring the ends out through an opening called a colostomy. The surgeon will make this opening in your belly.

The surgeon will also examine the bowel for lack of blood flow.

Why the Procedure Is Performed

A blockage in the bowel keeps stool from moving through. Gas gets trapped inside the bowel, and that causes swelling and abdominal distention. A blockage that lasts for a long time keeps blood from flowing normally. Poor blood flow can cause parts of the bowel to die.

Causes of intestinal obstruction include:

• Scar tissue (adhesions)
• Incarcerated hernias
• Tumors or cysts
• Intussusception
• Twisting or kinking of the bowel (volvulus)
• Swallowed objects not meant to be eaten

Surgery is often needed to treat a bowel obstruction. The type of operation depends on the cause of the obstruction.

Risks

Risks for any surgery are:

• Blood clots in the legs that may travel to the lungs
• Breathing problems
• Heart attack or stroke
• Infection, including in the lungs, urinary tract, and belly

Other risks of abdominal surgery are:

• Bowel leakage
• Formation of scar tissue (adhesions)
• Bowel obstruction after surgery
• Temporary paralysis (freezing up) of the bowel (paralytic ileus)
• Damage to nearby organs in the body
• Wound (incision) infection
• Wound opening up
• Bleeding inside your belly
• The edges of your intestines that are sewn together may open. This may cause life-threatening problems.
• More scar tissue may form in your belly and cause blockage of your intestines.
• Problems with colostomy or Ileostomy.

Before the Procedure

This surgery is usually done for two reasons:

• As a medical emergency
• When other medical treatments do not work for someone who is already in the hospital for treatment of a bowel obstruction

Because of this, most patients who have this surgery do not prepare for it the same way they would prepare for a surgery that is planned ahead of time.

After the Procedure

The time it takes to recover from bowel obstruction surgery depends on the specific type of operation that was done to correct the obstruction and on the person's general health.

Outlook (Prognosis)

The outcome is usually good if the obstruction is treated before tissue damage or tissue death occurs in the bowel. Some people may have more bowel obstruction in the future.

References

Turnage RH, Heldmann M, Cole P. Intestinal obstruction and illeus. In: Feldman M, Friedman LS, Sleisenger MH, eds. Sleisenger & Fordtran’s Gastrointestinal and Liver Disease. 8th ed. Philadelphia, Pa: Saunders Elsevier; 2006:chap 116.