SURGERY FOR THE SMALL INTESTINE

When is surgery for the small intestine needed?

Surgery may be needed for infections, inflammations, ulcers, or obstructions in the small intestine caused by inflammatory bowel disease, acid disease, peptic ulcers, Crohn's disease, bowel obstruction, bile duct conditions, bacteria, diverticular disease, or tumours.  In order to diagnose the condition and provide accurate treatment, an endoscopy or colonoscopy may be needed.

How is it done?

The surgery will differ depending on the condition that is being treated. Typically, under general anaesthesia, a portion of the small intestine is removed through open surgery or laparoscopic surgery. The two healthy ends of the intestine are then sewn together.

There are three sections of the small intestine, the duodenum, jejunum and the ileum. Depending on the condition and location of the ulcers or a tumour, a segmental bowel resection may be done one of these sections of the small intestine.

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If the portion which is removed, is too distant from the stomach, an opening may be made in the abdomen (a stoma) to allow waste to pass thru to a waste bag (colostomy bag). This is called an ileostomy and is usually temporary while the intestine heals, but may be permanent if a large part of the intestine is removed.

A Whipple procedure or pancreaticoduodenectomy may be done to remove part of the pancreas and stomach in addition to the small intestine. This procedure is most commonly done to remove tumours in this area which have spread to the pancreas thru the duodenum.

After surgery, you will be given instructions on how to care for your wound. You will be given pain medication and antibiotics to prevent infection. Intestinal functioning should go back to normal after a few weeks. Recovery is generally quicker when the surgery is done laparoscopically or endoscopically. It is essential to contact Dr Muthambi if you experience any of the following symptoms as emergency care may be needed:

  • High temperature or chills
  • Vomiting
  • Swelling around the incisions
  • Bleeding from the wound
  • Extreme pain

What are the risks of these surgeries?

  • Leaking from the intestine connection
  • Trouble with the stomach emptying
  • Trouble digesting some types of food
  • Changes in bowel habits
  • Weight loss

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