Our Summary

This research paper discusses a case where a 42-year-old man with a severe health issue (acute aortic dissection) that caused damage to his intestines, had to undergo emergency surgery to remove most of his small intestine and part of his large intestine. After the surgery, the patient’s digestive tract was not fully connected, which caused serious problems.

One problem was that the patient lost consciousness due to a chemical imbalance (metabolic alkalosis) caused by a large amount of fluid being discharged from a tube inserted into his stomach (gastrostomy). The other issue was that he developed jaundice (a yellowing of the skin) because his body was not properly processing bile salts, which are necessary for digestion.

To solve the jaundice issue, the patient’s stomach fluids were redirected into a part of his large intestine via the tube in his stomach and another in his colon (colostomy). This helped lower his bilirubin levels (a substance that causes jaundice when too high). After this, another surgery was performed to reconnect his digestive tract.

The main takeaway of the paper is that patients who undergo such extensive intestinal surgeries need careful management of their electrolytes and bile salts to prevent serious complications.

FAQs

  1. What complications can arise from an emergent bowel resection due to intestinal ischemia associated with acute aortic dissection?
  2. How can the complications from a subtotal resection of the small intestine be managed?
  3. What is the significance of restoring intestinal continuity after a massive bowel resection?

Doctor’s Tip

A helpful tip a doctor might tell a patient about intestinal resection is to follow a strict post-operative care plan, including monitoring electrolyte levels and bile salt depletion. It is important to communicate any changes in symptoms or complications to your healthcare provider promptly to prevent further complications. Additionally, maintaining a healthy diet and lifestyle can help support healing and recovery after intestinal resection surgery.

Suitable For

Patients who are typically recommended intestinal resection include those with:

  • Intestinal ischemia associated with acute aortic dissection
  • Extensive bowel necrosis
  • Short bowel syndrome
  • Bowel obstruction
  • Inflammatory bowel disease
  • Intestinal perforation
  • Intestinal tumors
  • Intestinal strictures
  • Intestinal fistulas

It is important for these patients to undergo careful evaluation by a healthcare provider to determine the appropriate course of treatment, which may include intestinal resection.

Timeline

Before intestinal resection:

  • Patient may present with symptoms such as severe abdominal pain, nausea, vomiting, and distension
  • Diagnostic tests such as CT scans, MRI, or angiography may be performed to confirm the diagnosis of intestinal ischemia
  • Emergent surgery is performed to resect the necrotic bowel and prevent further complications

After intestinal resection:

  • Patient undergoes surgery to remove the necrotic bowel and may require a colostomy or ileostomy to divert stool
  • Patient may experience complications such as metabolic alkalosis due to gastric discharge from a tube gastrostomy and jaundice due to disruption of the enterohepatic circulation
  • Management of electrolyte imbalances and bile salt depletion is crucial in the postoperative period
  • Second surgery may be performed to restore gastrointestinal continuity and prevent complications such as short bowel syndrome

What to Ask Your Doctor

  1. What is the reason for the intestinal resection and what are the potential risks and benefits of the procedure?
  2. What is the expected outcome of the surgery in terms of recovery and long-term effects on digestion and bowel function?
  3. How will my diet and nutrition needs change after the intestinal resection? Will I need to take any supplements or medications?
  4. What are the potential complications or side effects of the surgery, and how will they be managed?
  5. How long will the recovery process take, and what can I expect in terms of pain management and physical activity limitations?
  6. Will I need any follow-up procedures or treatments after the intestinal resection, such as stoma care or additional surgeries to restore gastrointestinal continuity?
  7. Are there any lifestyle changes or modifications I should make to support my digestive health after the surgery?
  8. How will the intestinal resection affect my overall health and quality of life in the long term?

Reference

Authors: Mohri K, Takeuchi E, Miyake H, Nagai H, Yoshioka Y, Okuno M, Yuasa N. Journal: Nagoya J Med Sci. 2019 Nov;81(4):711-716. doi: 10.18999/nagjms.81.4.711. PMID: 31849390