Our Summary

This research paper is about a medical condition called large bowel obstruction (LBO), which is responsible for almost 25% of all blockages in the bowel. It is considered a surgical emergency because of the high risk of the bowel tearing. LBO is the reason for 2% to 4% of all hospital surgical admissions. The most common cause of LBO is colon cancer, which accounts for about 60% of cases. Other causes can be abdominal adhesions, diverticulosis, hernia, inflammatory bowel disease, and in rare cases, endometriosis.

This paper focuses on a case of a 36-year-old woman who had an LBO, initially thought to be due to diverticulitis. However, it was later discovered that the blockage was caused by endometriosis tissue sticking to the wall of the colon and making the passageway of the intestine narrow. The woman came to the hospital emergency department with symptoms like nausea, vomiting, and stomach pain that started six weeks before. In this report, the researchers discuss this uncommon situation of endometriosis causing LBO, how it presents clinically, how it is diagnosed, and how it is managed.

FAQs

  1. What is a Large Bowel Obstruction and what causes it?
  2. How is endometriosis related to Large Bowel Obstruction?
  3. What is a sigmoidectomy and how is it used in the treatment of Large Bowel Obstruction?

Doctor’s Tip

One helpful tip a doctor might tell a patient about sigmoidectomy is to follow post-operative care instructions carefully to ensure proper healing and minimize the risk of complications. This may include maintaining a healthy diet, staying hydrated, avoiding heavy lifting, and taking prescribed medications as directed. It is also important to attend follow-up appointments with your healthcare provider to monitor your recovery progress.

Suitable For

Patients who are typically recommended sigmoidectomy are those with large bowel obstruction (LBO) caused by various pathologies such as colonic malignancy, diverticulosis, inflammatory bowel disease (IBD), hernia, and in rare cases, endometriosis. In cases where the obstruction is severe and does not respond to conservative management, surgical intervention such as sigmoidectomy may be necessary to remove the affected portion of the colon and alleviate the obstruction. Additionally, patients who are at a higher risk of bowel perforation or have recurrent episodes of LBO may also be recommended for sigmoidectomy to prevent further complications.

Timeline

  • Patient experiences symptoms such as nausea, vomiting, and abdominal pain for six weeks before presenting to the emergency department
  • Initial diagnosis is thought to be a complication of diverticulitis
  • Further investigation reveals that the obstruction is caused by endometriosis tissue adherence to the colonic wall
  • Patient undergoes laparoscopic surgery for endometriosis to address the obstruction
  • Sigmoidectomy is performed to remove the affected portion of the colon
  • Patient undergoes post-operative recovery and monitoring for any complications
  • Patient experiences improvement in symptoms and overall health after the surgery.

What to Ask Your Doctor

Some questions a patient should ask their doctor about sigmoidectomy could include:

  1. What is the reason for recommending a sigmoidectomy in my case?
  2. What are the potential risks and complications associated with this surgery?
  3. What is the expected recovery time and rehabilitation process after the surgery?
  4. Will I need a colostomy or ileostomy after the sigmoidectomy?
  5. What are the long-term effects or changes I can expect after the surgery?
  6. Are there any alternative treatments or procedures available for my condition?
  7. How many sigmoidectomies have you performed and what is your success rate?
  8. What is the expected outcome or prognosis after the sigmoidectomy?
  9. Will I need any additional treatments or follow-up care after the surgery?
  10. Are there any lifestyle changes or dietary restrictions I should be aware of post-surgery?

Reference

Authors: Plummer PD, Doorgen R, Yglesias B, Phillips JK. Journal: Cureus. 2022 Dec 12;14(12):e32430. doi: 10.7759/cureus.32430. eCollection 2022 Dec. PMID: 36644032