Small Bowell

You may need to have surgery to remove part of your bowel if you have a condition such as bowel cancer, diverticular disease, large polyps (fleshy growths), a problem with the blood supply to your bowel or inflammatory bowel disease (IBD). IBD is a term used for both Crohn's disease and ulcerative colitis.

The exact procedure you have will depend on the nature of your condition and on how much of your bowel is affected. An operation to remove part of your bowel is called a colectomy. Specific types of bowel surgery include the following.

• Total colectomy – removal of your entire bowel
• Proctocolectomy – removal of your entire bowel, the rectum (back passage) and anus
• Hemicolectomy – removal of either the left (descending) or right (ascending) side of your bowel
• Sigmoid colectomy – removal of the part of your bowel that is closest to your rectum and anus.
• Transverse colectomy – removal of the part of your bowel that joins the left and right sides (the transverse colon)
• Proctectomy – removal of your rectum and anus

Your bowel may be rejoined afterwards, or an artificial opening (stoma) may be created on your abdomen (tummy). This opening may be temporary or permanent.

Small-Intestine 1

Surgery on the small intestine is one of the most frequently done procedures in our surgical practice which include Small Bowel Obstruction Surgery and Small Bowel Resection Surgery.

The most common conditions leading on to small intestine surgery include.

Tuberculosis of the intestine

Small intestine is one of the common sites of tuberculosis in India. The small intestinal involvement is in the region of distal small bowel and proximal colon called ‘ileo-caecal tuberculosis’ This condition usually presents with progressive obstruction to the lumen of the bowel leading on to constipation and diarrhea. This requires surgical treatment in the form of limited resection of the ileo-caecal region.

Small-Intestine 2

Small bowel perforation

Typhoid ulcers leading onto perforation and peritonitis requiring emergency laparotomy and closure of perforation is not uncommon in our practice. This is an absolute emergency and should be tackled right away without delay.

Bleeding from the small bowel

Small bowel bleeding is uncommon and is difficult to diagnose. Often labeled as ‘obscure GI bleeding’ it can be slow chronic ooze or massive bleeding all of a sudden. This entity will require a variety of investigations like capsule endoscopy; enteroscopy and a nuclear scan to exactly localize the site of bleed which then has to be removed surgically.

Small-Intestine 3

Crohn’s Disease

Yet another condition of the small intestine seen more often these days than before, usually seen in young individuals with chronic diarrhea and weight loss. There are specific investigations available now to diagnose this condition with accuracy. Most of these patients will require long-term medical treatment. Some of them develop bowel obstruction, internal fistulae requiring repeated operations.

Tumor

Tumors of the small bowel are either adenocarcinoma or lymphoma presenting with bleeding and or obstruction. These need to be excised with a wide margin. Gastro-intestinal stromal tumors are seen quite often in the small intestine requiring excising a segment of the involved bowel.

Small-Intestine 4

Gangrene

Sudden occlusion of the blood supply to the small intestine leading on to gangrene of the small bowel causes severe abdominal pain and distension. This requires urgent accurate diagnosis and surgical removal of the damaged intestine.

Obstruction – incarceration in a hernia and trauma to the intestine are some of the other common conditions requiring surgery on the small intestine.