Small Bowel Surgery
Small intestine:
Surgery on the small intestine is one of the most frequently done
procedures in our surgical practice which include Small Bowel
Obstruction Surgery and Small Bowel Resection Surgery.
The most common conditions leading on to small intestine surgery
include:
- Tuberculosis of the intestine:
Small intestine is one of the common sites of tuberculosis in India.
The small intestinal involvement is in the region of distal small bowel
and proximal colon called ileo-caecal tuberculosis This
condition usually presents with progressive obstruction to the lumen of
the bowel leading on to constipation and diarrhea. This requires
surgical treatment in the form of limited resection of the ileo-caecal
region.
Typhoid ulcers leading onto perforation and peritonitis requiring
emergency laparotomy and closure of perforation is not uncommon in our
practice. This is an absolute emergency and should be tackled right away
without delay.
- Bleeding from the small bowel
Small bowel bleeding is uncommon and is difficult to diagnose.
Often labeled as obscure GI bleeding it can be slow chronic
ooze or massive bleeding all of a sudden. This entity will require a
variety of investigations like capsule endoscopy; enteroscopy and a
nuclear scan to exactly localize the site of bleed which then has to be
removed surgically.
Yet another condition of the small intestine seen more often these days
than before, usually seen in young individuals with chronic diarrhea and
weight loss. There are specific investigations available now to diagnose
this condition with accuracy. Most of these patients will require
long-term medical treatment. Some of them develop bowel obstruction,
internal fistulae requiring repeated operations.
Tumors of the small bowel are either adenocarcinoma or lymphoma
presenting with bleeding and or obstruction. These need to be excised
with a wide margin. Gastro-intestinal stromal tumors are seen quite
often in the small intestine requiring excising a segment of the
involved bowel.
Sudden occlusion of the blood supply to the small intestine leading on
to gangrene of the small bowel causes severe abdominal pain and
distension. This requires urgent accurate diagnosis and surgical removal
of the damaged intestine.
- Obstruction incarceration in a hernia and trauma to the
intestine are some of the other common conditions requiring surgery
on the small intestine.