One of the most frequently done procedures in surgical practice, surgery on the small intestine includes small bowel obstruction surgery and small bowel resection surgery.
Some of the most common conditions that lead to small intestine surgery include:
Tuberculosis, in India, commonly attacks on small intestine. The small intestinal association is in the part of distal small bowel and proximal colon called ‘ileo-caecal tuberculosis’. In this condition, there is usually a progressive obstruction to the lumen of the bowel that further leads to constipation and diarrhea. The condition requires surgical treatment in the form of limited resection of the ileo-caecal region.
Typhoid ulcers cause perforation and peritonitis which is an absolute emergency and should be tackled right away without delay. In this, laparotomy and closure of perforation is required.
Small bowel bleeding is an uncommon condition that is hard to diagnose. Often termed as ‘obscure GI bleeding’, it can lead to a slow chronic ooze or massive bleeding all of a sudden. For diagnosing this condition, there is required a variety of investigations like capsule endoscopy; enteroscopy and a nuclear scan. This exactly localizes the site of bleed which is removed surgically.
Crohn’s Disease is another condition of the small intestine with chronic diarrhea and weight loss. It can be seen more often these days than before. Now, there are available specific investigations to diagnose this condition with precision. Some of the patients may require long-term medical treatment. Several patients can also develop bowel obstruction, internal fistulae requiring repeated operations.
Tumors of the small bowel are either adenocarcinoma or lymphoma presenting with bleeding and or obstruction. These need to be removed with a wide margin. In the small intestine, gastrointestinal stromal tumors are seen quite often requiring excising a segment of the involved bowel.
Severe abdominal pain and distension is caused due to sudden occlusion of the blood supply to the small intestine leading on to gangrene of the small bowel. This requires surgical removal of the damaged intestine after urgent accurate diagnosis.