Intestinal obstruction repair

Repair of volvulus; Intestinal volvulus - repair; Bowel obstruction - repair

Intestinal obstruction repair is surgery to relieve a bowel obstruction. A bowel obstruction occurs when the contents of the intestines cannot pass through and exit the body. A complete obstruction is a surgical emergency.

Description

Intestinal obstruction repair is done while you are under general anesthesia. This means you are asleep and do not feel pain.

Your surgeon makes a cut in your belly to see your intestines. Sometimes, the surgery can be done using a laparoscope, which means smaller cuts are used.

Your surgeon locates the area of your intestine (bowel) that is blocked and unblocks it.

Any damaged parts of your bowel will be repaired or removed. This procedure is called bowel resection. If a section is removed, the healthy ends will be reconnected with stitches or staples. Sometimes, when part of the intestine is removed, the ends cannot be reconnected. If this happens, your surgeon will bring one end out through an opening in the abdominal wall. This may be done using a colostomy or ileostomy.

Why the Procedure Is Performed

This procedure is done to relieve a blockage in your intestine. A blockage that lasts for a long time can reduce or block blood flow to the area. This can cause the bowel to die.

Risks

Risks of anesthesia and surgery in general include:

Reactions to medicines
Breathing problems
Bleeding, blood clots, infection

Risks of this procedure:

Bowel obstruction after surgery
Damage to nearby organs in the body
Formation of scar tissue (adhesions)
Adhesions
Adhesions are bands of scar-like tissue that form between two surfaces inside the body and cause them to stick together.
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More scar tissue forming in your belly and causing a blockage of your intestines in the future
Opening of the edges of your intestines that are sewn together (anastomotic leak), which may cause life-threatening problems
Problems with the colostomy or ileostomy
Temporary paralysis (freezing up) of the bowel (paralytic ileus)
Paralytic ileus
Intestinal obstruction is a partial or complete blockage of the bowel. The contents of the intestine cannot pass through it.
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After the Procedure

How long it takes to recover depends on your overall health and the type of operation.

Outlook (Prognosis)

The outcome is usually good if the obstruction is treated before bowel blood flow is affected.

People who have had many abdominal surgeries may form scar tissue. They are more likely to have bowel obstructions in the future.

Open References

References

Galandiuk S, Netz U, Morpurgo E, et al. Colon and rectum. In: Townsend CM Jr, Beauchamp RD, Evers BM, Mattox KL, eds. Sabiston Textbook of Surgery. 21st ed. St Louis, MO: Elsevier; 2022:chap 52.

Mustain WC, Turnage RH. Intestinal obstruction. In: Feldman M, Friedman LS, Brandt LJ, eds. Sleisenger and Fordtran's Gastrointestinal and Liver Disease: Pathophysiology/Diagnosis/Management. 11th ed. Philadelphia, PA: Elsevier; 2021:chap 123.

Senagore AJ, Rojas-Khalil Y. Management of large bowel obstruction. In: Cameron JL, Cameron AM, eds. Current Surgical Therapy. 14th ed. Philadelphia, PA: Elsevier; 2023:209-214.

Before and after small intestine anastomosis - illustration
In all cases of intestinal obstruction, the intestine involved is carefully examined. If any parts of the intestine look unhealthy from lack of blood flow during the period of obstruction, they are removed and the healthy ends are reconnected. A patients recovery depends on the cause of the intestinal obstruction and the length of time prior to relief of the obstruction. The outcome is usually good if the obstruction is treated before damage (ischemia) or death (necrosis) of the bowel occurs.
Before and after small intestine anastomosis
illustration
Intestinal obstruction (pediatric) - series
Presentation

<strong>Intestinal obstruction (pediatric) - series</strong><p>The small intestine is basically a long tube through which digested food passes.</p>

<strong>Indications, part 1</strong><p>Intussusception is a common cause of bowel obstruction in children. It occurs when a segment of small bowel telescopes on itself, thus causing swelling, obstruction, and eventually intestinal gangrene.</p>

<strong>Indications, part 2</strong><p>Intussusception is suspected if the child has experienced sudden, severe abdominal pain, blood and mucous in the stool, and vomiting. Abdominal X-rays are usually taken to confirm the diagnosis. A barium enema may be used for diagnosis. Barium, a heavy, radio-opaque dye, is administered through the rectum, fills the bowel, and allows for visualization of the bowel by x-rays. This procedure is sometimes successful in correcting the problem - the weight of the barium itself in the bowel frequently reduces the telescoped bowel. If intussusception is diagnosed and not corrected by barium enema, surgery is necessary IMMEDIATELY to prevent complications such as obstruction, gangrenous bowel and peritonitis.</p>

<strong>Incision</strong><p>While the child is deep asleep and pain-free (using general anesthesia), an incision is made in the abdomen, usually in the midline. The bowel obstruction site is located, the obstruction is relieved, and the bowel is examined for injury. Injured sections are removed and the healthy ends of the bowel are either stitched together or brought out onto the abdomen temporarily (colostomy).</p>

<strong>Aftercare</strong><p>Generally, patients are able to go home within 5 to 10 days after surgery, depending on how long it takes the intestines to recover from the surgical procedure.</p>

Intestinal obstruction repair - series
Presentation

<strong>Intestinal obstruction repair - series</strong><p>The intestine is made up of the small intestine and the large intestine (colon). The small intestine runs from the stomach to the large intestine. The colon runs from the end of the small intestine to the anus. The intestine absorbs nutrients and water from the diet.</p>

<strong>Indication, part 1</strong><p>Obstruction of the intestine occurs when food and water cannot pass through the intestine. The area of intestine nearest to the obstruction becomes dilated and non-functioning. If the obstruction is not relieved, it can lead to intestinal gangrene and perforation.</p>

<strong>Indication, part 2</strong><p>The most common causes of intestinal obstruction in adults are adhesions, hernias, and colon cancer. Adhesions are scars that form between loops of intestine, usually caused by prior surgery, which causes such scar formation. Hernias are areas of weakness in the abdominal wall, through which loops of intestine can slip and become trapped. Colon cancer is one of the most common forms of cancer. While each reason for intestinal obstruction requires a different treatment, all intestinal obstructions are potentially life-threatening.</p>

<strong>Incision</strong><p>In most cases, surgery is necessary. While the patient is deep asleep and pain-free (general anesthesia), an incision is made in the midline of the abdomen. In the case of adhesions, the adhesion is removed, thus relieving the obstruction. In the case of a hernia, the hernia is repaired. If colon cancer is present, cancerous areas are removed, which also relieves the obstruction.</p>

<strong>Procedure</strong><p>In all cases, the intestine involved in the obstruction is examined. If any parts of the intestine look unhealthy from lack of blood flow during the period of obstruction, they are removed and the healthy ends are reconnected. A patient's recovery depends on several factors, including the cause of the intestinal obstruction and the length of time prior to relief of the obstruction.</p>

Before and after small intestine anastomosis - illustration
In all cases of intestinal obstruction, the intestine involved is carefully examined. If any parts of the intestine look unhealthy from lack of blood flow during the period of obstruction, they are removed and the healthy ends are reconnected. A patients recovery depends on the cause of the intestinal obstruction and the length of time prior to relief of the obstruction. The outcome is usually good if the obstruction is treated before damage (ischemia) or death (necrosis) of the bowel occurs.
Before and after small intestine anastomosis
illustration
Intestinal obstruction (pediatric) - series
Presentation

Intestinal obstruction repair - series
Presentation

A Closer Look

Self Care

Tests for Intestinal obstruction repair

Review Date: 3/31/2024

Reviewed By: Debra G. Wechter, MD, FACS, General Surgery Practice Specializing in Breast Cancer, Virginia Mason Medical Center, Seattle, WA. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

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Health Library

Intestinal obstruction repair

Bowel obstruction

Description

General anesthesia

Bowel resection

Colostomy

Ileostomy

Why the Procedure Is Performed

Risks

Adhesions

Paralytic ileus

After the Procedure