Today, we performed laparoscopic exploration and release of intestinal adhesions for a 33-year-old male patient with intestinal obstruction caused by intestinal adhesions after splenectomy surgery. But before this, the patient had to suffer from abdominal pain caused by intestinal obstruction once every half month, and for him, today was a relief. Looking at his smile, it is bittersweet to talk about those things of intestinal adhesions.
First, let’s take a look at a few pictures from his laparoscopic surgery.
The thick purple adhesions in the picture are tightly compressing the intestinal tube below it, making it impermeable and unable to fart!
The stretched intestine forms an acute angle, also called the intestine can’t breathe and can’t fart!
A spasm of the intestine causes him a burst of abdominal pain and bloating and nausea and vomiting, like a pinch of pain!
Multiple adhesions and streaks that were killing him!
What can I do to save you, my patient? The answer is two words: surgery!
What are intestinal adhesions?
Intestinal adhesions are adhesions between the intestine and the intestine, between the intestine and the omentum, between the intestine and the abdominal wall, or between the intestine and other organs caused by the disruption of the integrity of the peritoneum or peritonitis, collectively called intestinal adhesions.
So what is intestinal obstruction?
The inability of the intestinal contents (food, digestive or fecal matter and gas) to pass through the intestine or to be transported is called intestinal obstruction. The most common clinical cause of intestinal obstruction is intestinal adhesions.
What is the relationship between intestinal adhesions and intestinal obstruction?
After laparotomy, 90% have abdominal adhesions, 40% of which are intestinal adhesions, and of the intestinal adhesions, only about 20% cause intestinal obstruction, which we call adhesive intestinal obstruction. Having intestinal adhesions does not necessarily lead to intestinal obstruction, however, intestinal adhesions are a common and major cause of intestinal obstruction.
What are the manifestations of intestinal adhesions?
Mild intestinal adhesions mostly have no manifestation, occasionally there is slight pain and abdominal distension in the abdomen, etc. Heavy cases may often be accompanied by abdominal pain, abdominal distension, poor defecation and exhaustion, gas lumps in the abdomen and even cause intestinal obstruction.
What are the manifestations of intestinal obstruction?
4 manifestations you remember: abdominal pain, abdominal distension, nausea and vomiting, stop defecation and exhaust. The abdominal pain is mostly paroxysmal colic; abdominal distension shows that the stomach is bloated, serious like a drum; no bowel movement for several days without farting.
How do I know if I am suffering from intestinal obstruction?
If you have a history of abdominal surgery, especially open surgery, when you have paroxysmal abdominal pain, especially a burst of g pain, accompanied by nausea and vomiting, stopping bowel movements and exhaustion, it means you may suffer from intestinal adhesions and intestinal obstruction, you need to go to the hospital immediately, otherwise it will be life-threatening! Don’t say I didn’t warn you!
What to go to the hospital for?
One is to let the doctor see if you have intestinal obstruction caused by intestinal adhesions? The doctor will have to take pictures and laboratory tests for you to make a clear diagnosis, and if necessary, a CT.
What should I do if I am diagnosed with intestinal adhesions and intestinal obstruction?
1.For simple intestinal obstruction, incomplete obstruction especially extensive adhesions, non-applied surgical treatment is usually chosen, which requires hanging saline, applying antibiotics, inserting gastric tube to pump out the gas and liquid accumulated in the stomach and intestines, otherwise your intestines will be broken and will cause fatal peritonitis.
2.If adhesional intestinal obstruction is not improved by non-surgical treatment, and the condition is aggravated or suspected to be strangulated intestinal obstruction (intestinal necrosis, or even intestinal perforation), open surgery should be performed immediately. For recurrent and frequent episodes of adhesive intestinal obstruction, surgery should also be considered (the male patient mentioned at the beginning of the article belongs to this case).
What kind of surgery should be done?
Intestinal adhesion release or intestinal resection, the exact type of surgery is determined by the doctor depending on the degree of intestinal adhesion, the severity of the condition, the ischemia or necrosis of the intestine, and the age of the patient.
There are two types of surgery: open surgery and laparoscopic surgery, try to choose the latter, laparoscopic surgery can reduce the chance of re-intestinal adhesions and intestinal obstruction, but of course, it is also determined by your condition, local medical technology and your economic situation.
Anesthesia: Generally, epidural block anesthesia or general anesthesia is used. It is recommended to choose the latter, which is safe and effective!
Is there a way to prevent intestinal obstruction when there are intestinal adhesions?
Of course there is!
First of all, treat the disease early, do not wait until the disease is very serious and requires open surgery, that will be a problem, open surgery is the main cause of intestinal adhesions or intestinal obstruction.
If unfortunately open surgery, do not be discouraged, actively cooperate with the doctor, get off the floor early and move around more to speed up abdominal recovery and reduce the chance of intestinal adhesions.
once there are intestinal adhesions it is not terrible, most intestinal adhesions do not cause intestinal obstruction, as long as the intestine is not obstructed, adhesions will not do anything to you.
Even if intestinal adhesions cause intestinal obstruction, once out of F abdominal pain and bloating stop defecating and exhausting, please stop eating and drinking immediately, let yourself starve for a while, if still abdominal pain is more than, please go to the hospital emergency room immediately!