Doctor insights on:
Symptoms Of Anastomotic Leak Colectomy
I had a laparoscopic colectomy with ileorectal anastomosis surgery on 1/18 and I am experiencing cramping when I lay down and at night. Is this normal?
I recently had a total colectomy with ileorectal anastomosis for severe chronic inertiia that was unresponsive to other treatmentswhen they removed my colon they were surprised to find some areas of early stage cancer as well I had been undergoing regular
What is a subtotal colectomy with small bowel sigmoid anastomosis appearing at the level of upper pelvis mean?
Local vs peritonitis: Presumably this refers to an intra-abdominal anastamosis, likely intestinal. "Contained" means the leak was probably slow and there was time for an inflammatory reaction that kept the leak localized and maybe small. Free means intestinal contents leaked more widely into the abdominal cavity. Free is much more serious, usually with peritonitis. Most important that you discuss with your surgeon. ...Read more
Many possibilities: Many things can cause a leak--poor blood supply, too much tension on the anastomosis, poor nutrition, use of immunosuppresants such as steroids, infection, distal obstruction, etc. A recent large study from Germany showed a leak occurs in around 10% of cases. Sometimes it's treated with bowel rest and drainage of the fluid, sometimes it requires another operation. ...Read more
What causes an anastomotic leak? Is an Exploratory Laparotomy the procedure needed to correct? What are Exploratory Laparotomy usually needed for?
Variety of causes: Anastomotic leak is a term used to describe the breakdown between two surgically connected sites and is often used to describe GI anatomy. This may be where two pieces of bowel are brought together, or the outflow of an organ such as the liver or kidney is connected. When organs leak, infection in the abdomen can ensue. An exploratory laparotomy is the right choice to find and fix the leak. ...Read more
Will tiny anastomosis leak after a colon resection heal after two or more weeks of Invanz & TPN, along with colon resting?
Complex: If it is tiny, it should most likely resolve as the omentum seals it. Usually with a leak, bowel rest with TPN, antibiotics for a short period (not established) 2-4 weeks and +\- percutaneous drainage can replace the need for further surgery if the leak is tiny. Usually this requires a follow up CT study with oral contrast and many factors. (ID prespective) - may need surgery later ...Read more
I had a partial sigmoid colectomy ten months ago, diverticulitis symptoms gone. Still have chronic llq pain. Lifting left leg causes pain.
Colon resection: It can mean removal of part or complete colon with or without the rectum. ...Read more
If it is an elective: Operation, only rarely, depends on location of abnormality for which the colectomy is being done. If you need to have a complete procto-colectomy, yes, you would need a permanent colostomy. In all other cases, a colostomy would usually be a temporary one, even if necessary. If it is a right hemi-colectomy or an ileo-colectomy, chances of a stoma are very low. Ask your surgeon for specifics. ...Read more
No bag: A colostomy is performed when the bowel is resected and there is a significant length of proximal colon and minimal or no length of distal colon to bring the ends together as with an APR. When a stoma is present, irrigations should be started on a daily basis and a square pad placed over the stoma. With daily performance the colon will eventually function only when irrigation employed. ...Read more
Which one is better - colectomy or remicade (infliximab) for left sided colitis? Advice from 2 different gis.
Hard to say: It all depends. Surgery is usually reserved for medically refractory toxic disease or dysplasia/surgery. Most patients with severe disease will have an opportunity to respond to medications such as Remicade (infliximab) or cyclosporin before surgery is performed. Colectomy is curative but having an ipaa also presents problems. ...Read more
Can an Ileoproctostomy be performed after a subtotal colectomy with Ileostomy placement has already been done?
Yes: After removal of all colon to the peritoneal reflection or just below, there is a stump of distal bowel that remains. In many cases the surgeon can anastomosis proximal bowel to the anal stump at the levators. (the muscles of the rectal sphincter). If an exiting ileostomy is present, a pouch can be formed and anastomosed to the region just above rectum. ...Read more
I had a colectomy 4 months ago and now have a hernia the size of a grapefruit it has been starting to hurt, especially when I cough.
What do you suggest if my husband had a partial colectomy a month ago due to diverticulits. But now he is having internal hemmorhoids?
He should talk: With his surgeon and determine what is causing his hemorrhoid flare. Usually his surgery should not be a cause of hemorrhoid flare unless he has been constipated or having frequent diarrhea due to his surgery. Again his surgeon should be notified and evaluate your husband ...Read more
My husband had a partial colectomy a month ago due to diverticulits. But now he is having internal hemmorhoids. Could these be related?
No: He probably had the hemorrhoids before, but without symptoms. He probably was taking pain killer that will make him constipated, which can make the hemorrhoids to enlarged and cause pain with occasional bleeding. He should contact his surgeon and be evaluated. ...Read more
After colectomy, in first few weeks there is a frequent secretion of stool. Why is this? And colour of stool is that of what I eat. Why so?
Bowel irregularity: A change in bowel habits is normal after colectomy. This varies according to the segment removed and most change returns to normal in several weeks. Removal of some sections of the colon can cause a more prolonged chane (ie. Removal of the right colon along with the ileocecal valve). We usually advise our patients to maintain a low fiber diet for a week or two after colon rersection and give thing. ...Read more
Had a lap assisted right hemi colectomy 4 months ago. He had an episode of bleeding from his rectum about 1 month ago and is bleeding again. Why?
See surgeon: Cannot determine cause without looking. Could be as simple and innocent as hemorrhoids but too little information provided. Why was colectomy performed? Was it complicated? Has patient seen surgeon back in follow up. Recommend return to surgeon who performed operation. Also would suggest seeing a gastroenterologist. ...Read more
What parts would a patient need to have in order to be a candidate for Ileostomy Reversal after having had subtotal colectomy w/Ileostomy placement?
In 2012 had total Colectomy with j pouch and illiostomy. The illostomy reversal in 2013. Diareaha ever since. In pain and can't go anywhere what now.?
Here are some...: Constant diarrhea after total colectomy is much expected although some may adopt and adapt to the altered bowel reasonably well. All the possible care options would be dietary adjustment. For these related details, you should go back to your doctor and dietitian for specific detail since they have known your conditions more than anyone online. All the best to health... ...Read more
Yes: It depends on the reconstruction. If you have a j pouch and the contents are moving through rapidly and you have not adapted, a patient may have many stools per day and the area around the anus may be raw. Local treament with creams to the area are helpful. If it remains, your doctor can add things to thicken the stool or medicine to slow it done until you adapt. Good luck. ...Read more
Depends: This is highly dependent on why this surgery is indicated. If the person is not too elderly or have other risk factors such as crohn's disease or extensive cancer, then a j-pouch may be appropriate. This is performed by a trained surgeon who has the proper knowledge. Some patients do not have a choice due to their disease condition and will need an ileostomy. ...Read more