Our Summary

This paper talks about an 83-year-old man who had a history of benign pneumoperitoneum due to pneumatosis intestinalis, a condition where gas-filled cysts develop in the wall of the intestine. He was monitored over many years. However, he came to the Emergency Room due to symptoms of an intestinal blockage. The doctors decided that immediate surgery was needed. During the operation, they found that the obstruction was caused by pneumatosis intestinalis and the structure of the intestinal wall was damaged. The doctors removed the affected part of the small intestine and connected the healthy parts. The diagnosis was confirmed by the pathology report. The patient recovered well after surgery and had no symptoms a year later.

FAQs

  1. What is the primary cause of the intestinal obstruction in this patient?
  2. What surgical procedures were performed to treat the patient’s intestinal obstruction?
  3. How did the patient progress during the postoperative period, and what is their current condition?

Doctor’s Tip

One helpful tip a doctor might tell a patient about intestinal resection is to follow a strict postoperative diet to support healing and prevent complications. This may include eating small, frequent meals, avoiding high-fiber foods that could irritate the surgical site, staying hydrated, and gradually reintroducing solid foods as tolerated. Additionally, adhering to any prescribed medications, attending follow-up appointments, and reporting any unusual symptoms to your healthcare provider are essential for a successful recovery.

Suitable For

Patients who are typically recommended intestinal resection include those with:

  1. Intestinal obstruction: Patients who present with symptoms of intestinal obstruction, such as abdominal pain, bloating, vomiting, and constipation, may require intestinal resection to relieve the blockage.

  2. Pneumatosis intestinalis: Patients with pneumatosis intestinalis, a rare condition characterized by gas-filled cysts within the intestinal wall, may require intestinal resection if the condition causes complications such as perforation or obstruction.

  3. Intestinal ischemia: Patients with intestinal ischemia, a condition caused by reduced blood flow to the intestines, may require intestinal resection to remove damaged or dead tissue and restore blood flow to the remaining healthy tissue.

  4. Intestinal tumors: Patients with intestinal tumors, such as colorectal cancer or benign tumors, may require intestinal resection to remove the tumor and prevent further spread or complications.

  5. Inflammatory bowel disease: Patients with inflammatory bowel disease, such as Crohn’s disease or ulcerative colitis, may require intestinal resection if medical management is ineffective in controlling symptoms or if complications such as strictures or fistulas develop.

Overall, the decision to recommend intestinal resection is based on the specific condition and symptoms of the patient, as well as the risks and benefits of the surgical procedure. It is important for patients to discuss their treatment options with their healthcare provider to determine the most appropriate course of action.

Timeline

Before Intestinal Resection:

  • Patient has a past medical history of benign pneumoperitoneum secondary to pneumatosis intestinalis, with periodic follow-ups.
  • Patient experiences symptoms of intestinal obstruction and presents to the Emergency Room.
  • Urgent surgical management is decided and an exploratory laparotomy is performed.
  • Intestinal obstruction secondary to pneumatosis intestinalis is determined, with loss of structure of the intestinal wall visualized.
  • Resection of the affected small intestine segment and primary anastomosis are performed.

After Intestinal Resection:

  • Pathology report confirms the diagnosis of pneumatosis intestinalis.
  • Patient progresses favorably during the postoperative period.
  • Patient is currently asymptomatic after 12 months.

What to Ask Your Doctor

  1. What is the reason for the intestinal resection?
  2. What are the risks and potential complications associated with the surgery?
  3. How long is the recovery process expected to take?
  4. Will I need any additional treatments or medications after the surgery?
  5. What dietary changes or restrictions should I follow after the procedure?
  6. How often will I need follow-up appointments to monitor my progress?
  7. Are there any long-term effects or concerns I should be aware of following the resection?
  8. Are there any specific symptoms or signs I should watch for that may indicate a complication?
  9. Will I need any additional imaging or tests in the future to monitor my intestinal health?
  10. Are there any lifestyle changes I should consider to help prevent future issues with my intestines?

Reference

Authors: Ocharán M, González López R, Vázquez González I, García Melón A, Lenza Trigo P, Anguita Ramos F, Conde Vales J. Journal: Rev Esp Enferm Dig. 2023 Jun;115(6):344-345. doi: 10.17235/reed.2023.9608/2023. PMID: 37170538