Re: partial bowel obstruction

From: Howard McCollister (nospam_at_nospam.net)
Date: 08/11/04 

Date: 10 Aug 2004 22:51:21 -0500

"Damian Breem" <Breem54@hotmail.com> wrote in message
news:5be75e93.0408100642.2cbba3f7@posting.google.com...

>
> Again thank you for your response. I have done more reading on
> diverticulitis and I am a little more discouraged. They all mention
> the ribbon stool and that it requires surgery to fix it is just not an
> emergency which I am very thankful for. But having already had a
> sigmoid resection I am concerned that they would have to take more or
> worse end up with a colostomy at some point. I am a pretty upbeat
> person so I will get passed this discouragment and deal with whatever
> is coming.
>
> Thanks again, having this information will be very helpful when I see
> the Dr tomorrow.
>

The majority of diverticuli occur in the sigmoid colon where segmentation
pressures are definitely the highest and cause the diverticuli to occur.
Your surgeon removed at least part of your sigmoid colon. He may not have
removed enough of it, but that sometimes happens, especially if he's dealing
with an acute diverticulitis. His goal may have been to remove primarily the
infected segment and deal with the short term problem with the hope that a
subsequent high-fiber diet would help control chances of recurrent
diverticulits later on. I personally think this is the wrong approach, and
that an aggressive sigmoid resection, even in the face of acute
diverticulitis, is a better approach. It would be very unusual that an
aggressive sigmoid resection would prevent hooking up the descending or
tranverse colon to the rectum (as opposed to permanent colostomy).

A permanent colostomy is a pretty unlikely consequence of diverticultitis.
They may indeed need to re-operate and take more if there is recurrent
diverticulitis as the source of your problem, but in the vast majority of
circumstances, this is a do-able operation without permanent colostomy. I
would consider this to be very unusual in the hands of a competent surgeon.

Let the gastroenterologist work on the diagnostic end - first ruling out (or
in) recurrent diverticulits. If that is indeed the case, be cautious about
advice on this surgical problem from a non-surgeon. Make sure you seek
additional advice from a surgeon who know his or her way around the colon. A
competent colo-rectal surgeon is a good idea. A laparoendoscopic surgeon
with experience at colon resection would be better, and best would be a
colo-rectal surgeon skilled at laparoscopic colon resection (although these
are generall pretty hard to find).

HMc

Relevant Pages

  • Re: partial bowel obstruction
    ... I had a sigmoid resection due to ... I could have sworn that the surgeon said I had a ... >> the bowel was stuck resulting in a partial small bowel obstruction. ... >> was found to be either diverticulitis or adhesions causing this ...
    (sci.med)
  • Re: partial bowel obstruction
    ... I had a sigmoid resection due to ... > the bowel was stuck resulting in a partial small bowel obstruction. ... > was found to be either diverticulitis or adhesions causing this ... The surgeon would have removed that obstructive band at your operation, ...
    (sci.med)
  • Re: Back from the dead
    ... Two friends had Diverticulitis, had surgery and both are and have been, ... weakening the colon wall. ... foods and take a daily fiber supplement. ...
    (rec.sport.billiard)
  • Re: partial bowel obstruction
    ... >> diverticulitis and I am a little more discouraged. ... > Your surgeon removed at least part of your sigmoid colon. ... > that an aggressive sigmoid resection, even in the face of acute ... > would consider this to be very unusual in the hands of a competent surgeon. ...
    (sci.med)
  • Re: Diverticulosis and Diverticulitis Questions ?
    ... > Concerning Diverticulosis and Diverticulitis: ... Colonoscopy will usually identify diverticuli in the colon. ... A barium enema is probably more useful for that, ...
    (sci.med)
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