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.
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
None: Vitamins and minerals are absorbed in the small intestine and not the colon. So unlikely to develop vitamin or trace mineral deficiency. An electrolyte abnormality may ensue but the patient and the doctor would know this as the symptoms would not go unnoticed. ...Read moreSee 1 more doctor answer
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 moreSee 1 more doctor answer