Enterectomy (small bowel resection)

The Condition

The patient may have a tumor or inflammation in the small intestine. This can cause bleeding, pain, obstruction, or other problems, so surgical removal usually is indicated.  

The procedure

The surgery can be done open or laparoscopically.  For the open approach a large incision is made on the abdominal wall.  For the laparoscopic approach the surgeon will make about 3-4 small incisions in the abdomen. A port (nozzle) is inserted into one of the slits, and carbon dioxide gas inflates the abdomen. This process allows the surgeon to see inside of the abdomen more easily. A laparoscope is inserted through another port. The laparoscope looks like a telescope with a light and camera on the end so the surgeon can see inside the abdomen. Surgical instruments are placed in the other small openings and used to remove the diseased portion of the small bowel. The specimen of small bowel then is placed into a plastic bag, and removed through one of the small incisions. The bowel is re-connected with surgical staplers that fit through the ports. After this has been accomplished, the carbon dioxide is released out of the abdomen through the slits, and then these sites are closed with sutures or staples, or covered with glue-like bandage and steri-strips.

Symptoms

• Nausea and vomiting
• Crampy pain abdominal pain
• Diarrhea
• Internal bleeding
• Weight loss, weakness

Nonsurgical Treatment

If the patient has a mass or tumor in the small bowel, then this is best treated with surgery. Inflammatory bowel disease (Crohn’s Disease, Ulcerative Colitis) can be treated with medication.  Surgery for IBD is usually done because of complications of the disease.

Risks

• Infection of the skin at the incision site
• Collection of pus inside the abdomen (intra-abdominal abscess)
• Postoperative ileus (the intestines slow down/stop working for several days)
• Small bowel obstruction (kinking, twisting, or scarring which blocks the bowel)
• Leakage from the intestinal connection

Medical negligence

The above mentioned risks and complications are known to happen with enterectomy (small bowel resection) and such complications do not necessarily constitute deviation from the medical standard of care.  The following examples however may be considered as medical negligence.

• Failure to diagnose and treat intestinal leak despite the fact that symptoms, signs, and laboratory results indicate such.
• Failure to diagnose and treat in a timely fashion intestinal ischemia (reduced or restricted blood supply to the bowel)