Dr. Ferzli's Procedures
Specializing in Minimally-Invasive Surgery
Small Intestine Blockage Surgery
There are a number of disease processes that can occur in the small intestine that may require surgical management.
Intususception is a problem that occurs when one portion of the bowel is drawn into an adjacent segment of bowel. This problem can resolve by itself but may result in a dangerous bowel obstruction. Although intussusception usually occurs in children, it can also happen to adults. When an adult develops an intususception it usually is because of an underlying tumor. Surgery is often needed to uncover the cause of the intussusception and to treat the obstruction.
Adhesions sometimes result in patients who have undergone surgery. An adhesion is a type of scar tissue that forms within the abdominal cavity. An adhesion can kink the bowel and can result in pain or in a dangerous obstruction. Occasionally adhesions can form in a patient who has never had abdominal surgery. This may occur in about 3% of people who develop adhesions. Often adhesions that result in pain or obstruction require surgery to free the bowel and relieve an obstruction.
An internal hernia occurs when bowel slips into a space or opening within the abdominal cavity. These spaces are usually the result of prior surgery or trauma. An internal hernia can lead to abdominal pain, bloating, obstruction, and sometimes gangrene of the intestine. An internal hernia is an emergency and warrants urgent surgery.
A Meckle's diverticulum is an out-pouching that occurs near the end of the small bowel in about 2% of the population. Most Meckle's diverticula never develop symptomatic problems. Among the problems that can result that require surgery are: bleeding from the diverticulum, volvulus (twisting of the bowel) around the diverticulum, intussusception (see above), diverticulitis (inflammation and infection of a diverticulum), and cancer in the diverticulum. When symptomatic, a Meckle's diverticulum can be resected via a laparoscopic approach.
Crohn's Disease is a type of inflammatory bowel disease that can occur anywhere along the GI tract. Among the problems that can occur in Crohn's are small bowel strictures, bowel obstruction, and fistula formation. Laparoscopic surgery has been proven to be a useful way to treat Crohn's disease that requires surgery.
Although cancer of the small intestine is rare, there are number of small bowel neolplasms that can be treated with laparoscopy:
• Adenocarcinomas are tumors that rarely affect the small bowel but, when present, can spread to other organs and usually require removal with surgery.
• Lymphoma is a type of cancer of the lymphatic system. In some cases it can be isolated to the bowel, but it often affects other organ systems. The usual treatment is chemotherapy, but small bowel lymphoma sometimes requires surgery for obstruction, perforation, or to obtain a diagnosis.
• Carcinoid tumors are a type of tumor of the endocrine system. They can present with a wide array of symptoms including severe diarrhea, wheezing, and flushing of the skin. The symptoms of carcinoid tumor (or "carcinoid syndrome") can be helped with medication, but surgery is needed for cure of the tumor or, in some cases, to help alleviate severe symptoms.
Lipoma, leiomyoma, and adenoma are all examples of benign tumors that can grow within the small bowel tract. These tumors can present with a variety of vague symptoms including dull pain, bloating, and loss of appetite. Usually surgery is indicated to treat these tumors in order to alleviate these symptoms, prevent obstruction of the small intestine, and to obtain a clear diagnosis.
For further information, you can ask Dr. Ferzli.