Intestinal obstruction repair

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Alternative names
Repair of volvulus; Reduction of intussusception

Definition

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

Description

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:

• Band of fibrous or scar tissue (adhesions)
  
• Incarcerated hernias
  
• Tumors or cysts
  
• Telescoping of a portion of bowel into another portion (intussusception)
  
• Twisting or kinking of the bowel (volvulus)
  
• Swallowed objects (foreign bodies)

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 the 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).

If possible, injured sections are removed and the healthy ends of the bowel are stitched together (resection). If resection is not possible, the ends are brought out through an opening in the abdomen (ostomy).

Indications

Surgery is frequently needed to treat a bowel obstruction, but the type of operation depends on the cause of the obstruction (e.g., adhesions, tumor, incarcerated hernia). The cause of the obstruction and the need for surgery are determined by your doctor based on your history, physical exam, and radiologic studies.

RISKS
Risks for any anesthesia include the following:

• Reactions to medications
  
• Problems breathing

Risks for any surgery include the following:

• Bleeding
  
• Infection

Other risks of abdominal surgery include the following:

• Bowel leaks
  
• Formation of scar tissue (adhesions)
  
• Bowel obstruction after surgery
  
• Temporary paralysis of the bowel (paralytic ileus)

Expectations after surgery
The outcome is usually good if the obstruction is treated before tissue damage or tissue death occurs in the bowel.

Convalescence

The recovery period from bowel obstruction surgery is highly variable. It depends on the magnitude of the operation needed to correct the obstruction and the amount of time it takes the body to recover from the operation.

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