Small Intestinal Obstruction (Intestinal Knot)
The most common disease in the small intestine is obstruction. The cause of obstruction is almost always adhesions between the intestines or hernias in the abdominal wall after a previous abdominal surgery.
Although the prevention of adhesions that develop after abdominal surgeries is a very important research area of surgery, no definitive success has yet been achieved in this regard.
Laparoscopic (closed) surgeries generally cause less adhesion than open surgeries, but it is not possible to definitively prevent intestinal obstruction due to adhesion.
Intestinal sections can also enter abdominal wall hernias and get stuck there, causing obstruction.
Patients have widespread abdominal pain, restlessness, nausea and vomiting. Even if they defecate several times, patients are unable to pass gas and their abdomen is swollen.
We quickly start giving fluids intravenously and begin examinations to find the cause of the obstruction. If there is a strangulated hernia, it requires urgent surgery. If we are considering surgery-related adhesion, we do not rush for surgery. If necessary, we insert a tube into the nose of the patients and monitor them. We provide nutrition intravenously. The majority of these patients begin to pass gas within 24 – 48 hours. Thus, there is no need for a new surgery. However, if worsening is detected during follow-up, urgent intervention is required.
Crohn's Disease
It is a disease from the inflammatory bowel diseases group. In fact, although it may affect the entire digestive system from the mouth to the anus, it is most commonly seen in the last part of the small intestine. It progresses with thickening and inflammation in the intestine. The exact cause is unknown. Many different factors are to blame. It probably occurs due to the combination of more than one reason. Patients may have symptoms similar to intestinal obstruction, or it may behave like appendicitis.
Since surgery is not the definitive solution for this disease, which needs to be monitored and treated with joint efforts of branches such as gastroenterology, surgery and radiology, we avoid surgery as much as possible and, when necessary, remove the relevant section of the intestine. Unfortunately, although rare, sometimes procedures such as tying the intestine to the abdominal wall may be required.
