Perforated Bowel Surgery

The digestive system of the human body comprises various organs that help in breaking down the food into a form that can be easily assimilated. Various organs work collectively in order to break down the food we ingest, which in turn, provides the cells of the body with the much-needed energy.

Right from the mouth, wherein the food gets masticated, to the stomach and the small intestine, digestive enzymes work on the food to break it down further. The large intestine or the colon performs the task of removing water and electrolytes from the food, and the solid waste is then stored in the rectum and excreted out through the anus.

Malfunctioning or improper functioning of any of these digestive organs is most likely to have an adverse impact on one's health. A perforated bowel, also known as intestinal perforation, is one such condition wherein a perforation or a hole in any part of the intestine, causes the contents of the intestine to spill over into the abdominal cavity.

A person diagnosed with this condition will have to undergo a perforated bowel surgery so as to prevent any serious complications from arising. Here's some information on the causes, symptoms and treatment of intestinal perforation.

Both the small as well as large intestine play a vital role in the digestion of food. Small intestine helps in the digestion of food and assimilation of the nutrients whereas the large intestine aids in the disposal of waste products from the body.

A perforation in the intestines can undoubtedly, undo the work done by the other organs of the digestive system. A hole in the intestinal walls can cause spillage of the contents into the abdominal cavity, which in turn, can inflame the membrane that lines the abdominal cavity.

Pain in the abdomen, vomiting, bloody stools, nausea and other bowel problems may be felt as a result of this condition. One can also not rule out the possibility of sepsis or a blood infection.

If medical assistance is not sought at the right time, one may even face a life-threatening situation due to sepsis. If this surgery is performed at the right time, such a medical emergency can be easily averted.

Trauma to the abdomen during a surgery or diagnostic procedures like colonoscopy or enema may cause a intestinal perforation. Certain medical conditions can also make one susceptible to this condition. Inflammation of the appendix is one such condition that could increase the risk of an intestinal perforation.

Appendix, which is a narrow finger-like pouch situated at the junction of ileum from the small intestine and cecum from the large intestine, could get inflamed due to inflammatory bowel conditions such as Crohn's disease or ulcerative colitis.

At times, benign or malignant cancerous growth in the intestine can also make one more susceptible to intestinal perforation. Pathogenic conditions caused by infestation of parasites can also cause perforations in the intestines.

Intestinal perforation could even turn out to be a self-inflicted problem. One may develop this problem if one accidentally swallowed a bone while rushing down a meal.

A perforation in the intestine increases the possibility of an infection. The only way to prevent any serious complications from arising is to repair the perforation and prevent any further leakage of digested food or wastes into the abdomen.

Drug therapy alone wouldn't suffice when it comes to perforated bowel treatment, but it surely is an important part of the treatment. Diagnostic procedures such as CT scans, X-ray or colonoscopy can provide the surgeons the information regarding the size as well as the location of the perforation in the bowel.

Surgery for intestinal perforation is categorized into open surgery or keyhole surgery. Once the doctors have analyzed the patient's medical history, they can decide which one of the aforementioned surgical procedures, is more suitable.

 In case of an open surgery, the abdomen is cut open by making a large incision. Prior to the surgery, Hartmann solution is administered intravenously so as to compensate for the loss of body fluid and mineral salts. Since, infection at the site of incision is one of the most common complications, antibiotics are usually administered intravenously.

In order to prevent the wastes from the intestine from spilling into the abdomen, a nasogastric suction tube is used for emptying the wastes from the intestine. After that, the perforation can be repaired and the incision can be sutured.

Sometimes, a medical condition that the patient may be suffering from, can make open surgery nonviable and risky. This the reason behind the increasing popularity of the minimally invasive laparoscopic surgery. With the advancements in the field of medicine, sophisticated surgical tools and devices have been developed.

A laparoscope is one such device that is used for minimizing the risks associated with surgery. The laparoscopic surgery is a minimally invasive surgery, wherein instead of a large incisions, a fewer number of small-sized incisions can accomplish the task of repairing the intestinal perforation.

The incisions are smaller, so the risk of infection is lesser and the healing time is also considerably lower in comparison to an open surgery. Suctioning of wastes through nasogastric suction tube and intravenous administration of Hartmann solution and antibiotics are procedures that are common to open surgery as well as laparoscopic surgery.

The surgery starts with inflation of the abdominal cavity through carbon dioxide. The next step is to make smaller incisions and insert a laparoscope through one of these cuts.

Since, a mini-camera is attached to the laparoscope, the interiors of the abdomen can be viewed on a video monitor. The visuals on the video monitor guide the doctors as they insert small instruments and repair the perforation in the bowel.

Both these surgeries can also be used for treating other anatomical abnormalities that may be present. If a cancerous growth is the underlying cause of the perforation, the diseased part of the intestine will need to be removed.

Once the defect in the intestinal wall is repaired, the incision would be sutured. The time one may take to recover from this surgery usually ranges from seven to eight weeks. However, one may take longer to recover if any complications develop after the surgery. The patient must, therefore, follow certain self-care measures post surgery.

The patient must not lift heavy objects for at least a couple of months after the surgery. He/she must also complete the course of antibiotics and follow the dietary guidelines after the surgery.

If the perforation was caused due to an underlying disease, that particular disease must be treated. If that medical condition remains unresolved, there is the risk of recurrence of intestinal perforation in future. Complying with the guidelines regarding drug therapy or other form of treatment recommended by the doctor will ensure faster healing.

A perforation in the gastrointestinal tract is a condition, which if left untreated, may become a cause of grave concern. The risk of sepsis makes it a life-threatening condition. Bowel problems therefore, must never be overlooked.

If a person experiences a sudden change in bowel habits or irregularities in the bowel movements, he/she must have a thorough medical checkup done at the earliest. One must also follow a healthy diet and make the right lifestyle choices in order to prevent bowel problems in future.