SMALL-BOWEL RESECTION

General Information

DEFINITION-Removal of diseased section of the small bowel (small intestine).

BODY PARTS INVOLVED-Small intestine, including muscles and peritoneum layer around it.

REASONS FOR SURGERY

• Tumor, gangrene, narrowing or obstruction in the small intestine.
• Trauma, such as from a wound.

SURGICAL RISK INCREASES WITH

• Adults over 60.
• Obesity.
• Smoking.
• Poor nutrition.
• Previous abdominal surgery.
• Recent or chronic illness.
• Use of drugs such as: antihypertensives; muscle relaxants; tranquilizers; sleep inducers; insulin; sedatives; beta-adrenergic blockers; or cortisone.
• Use of mind-altering drugs, including: narcotics; psychedelics; hallucinogens; marijuana; sedatives; hypnotics; or cocaine.

What To Expect

WHO OPERATES-General surgeon.

WHERE PERFORMED-Hospital.

DIAGNOSTIC TESTS

• Before surgery: Blood and urine studies; x-rays of chest and gastrointestinal tract; CT or MRI (See Glossary for both).
• After surgery: Blood studies.

ANESTHESIA-General anesthesia by injection and inhalation with an airway tube placed in the windpipe or spinal anesthesia (See Glossary).

DESCRIPTION OF OPERATION

• Operative procedures will vary depending on the cause.
• An incision is made in the abdomen.
• The muscles are separated or cut, and the abdominal cavity is entered.
• The intestine is examined for disease.
• The small intestine is clamped above and below the diseased section. The diseased section between the clamps is cut free and removed.
• The two open ends of the remaining small bowel are fastened together with sutures or staples. Occasionally, a temporary ileostomy (see Surgery section) is necessary.
• The peritoneum and muscles are closed with sutures. The skin is closed with sutures or clips, which usually can be removed about 1 week after surgery.

POSSIBLE COMPLICATIONS

• Excessive bleeding.
• Surgical-wound infection.
• Recurrence of intestinal obstructions caused by adhesions.

AVERAGE HOSPITAL STAY-7 to 10 days.

PROBABLE OUTCOME-Expect complete healing of surgical wound. Allow about 4 weeks for recovery from surgery.

Postoperative Care

† Move and elevate legs often while resting in bed to decrease the likelihood of deep--vein blood clots.

† You may use non--prescription drugs, such as acetaminophen, for minor pain.

ACTIVITY

• Return to daily activities and work as soon as possible to promote healing.
• Avoid vigorous exercise for 6 weeks after surgery.
• Resume driving 3 weeks after returning home.

DIET--Intravenous feeding with nasogastric suctioning for several days, then return slowly to a diet your doctor will prescribe.

Call Your Doctor If

† Pain, swelling, redness, drainage or bleeding increases in the surgical area.

• You develop signs of infection: headache, muscle aches, dizziness or a general ill feeling and fever.
• You experience nausea, vomiting, constipation, abdominal swelling, or bloody or tarry stools.
• New, unexplained symptoms develop. Drugs used in treatment may produce side effects.