Intestinal obstruction after surgery: What you need to know

The article is professionally consulted by resident Doctor Le Thanh Tuan - Department of General Surgery - Vinmec Nha Trang International General Hospital.

Complications of intestinal obstruction can occur late or early after surgery. Intestinal obstruction appeared a few days after surgery or occurred while the patient was still hospitalized during the postoperative follow-up period. There are also many cases of intestinal obstruction that can occur after the patient has returned to normal activities. Even intestinal obstruction occurs after a long period of years after surgery.
For the case where the patient is still being monitored in the hospital, the management will be easier, sometimes just inserting a suction tube to deflate the intestines and giving fluids, the patient can be stable, no bowel obstruction and no need for intervention. Severe intervention by surgery.

Doctors believe that there are many causes of intestinal obstruction after surgery in patients, in which some typical causes can be mentioned such as:
Due to the surgical process, peritoneal tissues, abdominal wall or the body. The intestinal body is twisted and damaged and during the healing process, the tissues will stick together or create ligaments, causing the intestines to get stuck and twisted into it, difficult to come out, causing intestinal obstruction. Due to small foreign bodies falling into the abdomen such as food, surgical threads ... are organized to create sticky fibers that cause intestinal obstruction. Because the intestinal loops are paralyzed, they cannot function, causing intestinal obstruction. The cases of sticky torsion will stay in place until there is a chance to cause intestinal obstruction later. Because the loops of intestines can pass through the holes inside the abdomen or the hernia holes in the abdominal wall are located here, causing intestinal obstruction.

Patients with complications of intestinal obstruction after surgery often have obvious symptoms as follows:
Increasing nausea and vomiting. Patient does not have a bowel movement. Abdominal pain, the pain is getting worse. The abdomen is increasingly distended. Peristalsis has signs like snake crawling, increasing intestinal peristalsis. When there are clinical signs, the patient continues to be diagnosed by paraclinical methods and detect specific signs more accurately by:
Ultrasound shows dilated bowel loops, fluid in the abdomen , associated with intrauterine or surgical site infection. An unprepared abdominal X-ray shows one or more dilated loops of bowel with a fluid level that is usually the small intestine. In addition, the patient will also have a complete blood count test showing signs of infection, increased white blood cells, blood urea, and an ionogram showing fluid and electrolyte disturbances. In many cases, patients are subjective with clinical signs, the abdominal pain will become more and more intense, with dizziness, sweating, paleness, or blood in the stool. If not treated promptly, it can lead to necrotic bowel volvulus, which is life-threatening.

For effective and timely treatment of intestinal obstruction after surgery, the patient will be handled by the doctor depending on the condition and cause of each person's bowel obstruction. For the case of intestinal obstruction immediately after surgery, still in the hospital stay after surgery, the treatment will be easier and more timely.
The case of intestinal obstruction long after surgery will be more complicated in treatment, because of many reasons such as the patient's subjectivity easily leading to severe and serious intestinal obstruction or due to many different causes. Some cases of bowel obstruction will require surgery to stabilize the situation.
Thus, the post-operative monitoring, early detection of the clinical symptoms of intestinal obstruction mentioned above will make the management and treatment easier and safer for the patient. In addition, patients need to know how to prevent intestinal obstruction after surgery.

Intestinal obstruction is partly related to the patient's lifestyle and diet after surgery. In order to avoid intestinal obstruction, in the postoperative period, the patient needs to be mobilized early, suitable for physical strength to avoid the intestines being sluggish, leading to the risk of sticking together. Doctors recommend that patients should sit up early, move around the bed immediately after surgery from the 2nd day onwards, depending on their fitness after surgery. This helps the intestines to return to circulation and soon have a peristalsis. When the intestines are functioning properly soon, they will slide on top of each other and avoid intestinal adhesions.
Besides, diet also plays an important role in avoiding intestinal obstruction. Children and the elderly should avoid fibrous foods such as bamboo shoots, melons, spinach...; fruits with a lot of tannin such as guava, persimmon because these foods cause adhesion together, easily forming food residues, causing blockage in the intussusception.
Doctor Le Thanh Tuan has experience in examination, treatment and surgery of abdominal diseases (both open surgery and laparoscopic surgery). In particular, the doctor has strengths in pediatric surgery to treat diseases such as: intussusception, appendicitis, inguinal hernia, postpartum malformations (fetal peritonitis, megacolon, no anus).