Large bowel resection
| Normal anatomy |
|
The large bowel [large intestine or the colon] is part of the
digestive system. It runs from the small intestine to the rectum.
It is made up of three portions; the ascending, transverse and
descending colon. The ascending colon is sometimes referred to as
the right colon; the descending colon is sometimes referred to as
the left, or sigmoid colon. |
| Indications |
|
Bowel resection may be indicated for:
- blockage of the intestine (intestinal obstruction) due to scar
tissue or tumors
- bleeding, due to diverticulosis or arteriovenous
malformations
- injuries
- cancer
- precancerous polyps
- familial polyposis
- infection, due to diverticulitis
|
| Incision |
|
The patient is deep asleep and pain-free (general anesthesia). A
lower midline incision is made in the abdomen. Sometimes, the
surgeon will use a lateral lower transverse incision instead." |
| Procedure, part 1 |
|
The diseased part of the large intestine (colon) is removed. The
two healthy ends are then sewn or stapled back together and the
incision is closed. A stapling procedure is shown here. |
| Procedure, part 2 |
|
If it is necessary to spare the intestine from its normal digestive
work while it heals, a temporary opening of the intestine onto the
abdomen (colostomy) may be done. A temporary colostomy will be
closed and repaired later. If a large portion of the bowel is
removed, the colostomy may be permanent. The large intestine
(colon) absorbs most of the fluid from foods. When the colon is
bypassed by a colostomy in the right colon, the colostomy output is
generally liquid stool (feces). If the colon is bypassed in the
left colon, the colostomy output is generally more solid stool. The
constant or frequent drainage of liquid stool can cause the skin
around the colostomy to become inflamed. Careful skin care and a
well-fitting colostomy bag can reduce this irritation. |
| Aftercare |
|
Most patients will stay in the hospital for 5 to 7 days. Complete
recovery from surgery may take 2 months. During the first few days
after surgery, eating is restricted. |
Review Date: 1/26/2009
Reviewed By: Robert A. Cowles, MD, Assistant Professor of Surgery,
Columbia University College of Physicians and Surgeons, New York,
NY. Review provided by VeriMed Healthcare Network. Also reviewed by
David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.
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