Removal of the colon is called a colectomy which is done for a variety of reasons, such as a bowel obstruction, perforation of the bowel, trauma, Crohn's disease, ulcerative colitis or cancer of the colon. A total or partial colectomy or a right or left hemicolectomy may be done. A proctocolectomy removes the entire colon and rectum. These major surgical procedures usually go well, however there are possible problems or complications.
Bleeding
Postoperative bleeding could occur internally due to a possible injury to an organ during the surgery or there could be bleeding from the site of the incision. Internal bleeding will be suspected if there is a sudden drop in blood pressure and there might be obvious abdominal distention. Internal bleeding must be treated as an emergency. The patient will be returned to surgery for abdominal exploration and repair. Bleeding from the incision site could also occur. This will also be corrected in surgery.
Wound Infection
The wound could become infected. This will be treated by an antibiotic to prevent further infection and promote wound healing. Proper cleaning, change of dressing and care of the wound will be necessary.
Injury To Surrounding Organs
The surrounding organs in the abdomen that are close to the colon will be protected from injury. However there may be an inadvertent injury to a abdominal organs like the liver, bladder, a blood vessel, damage to a nerve or to the ureter. Any such injury will be repaired at the time of injury.
Leak At The Anastomosis Site
A leak may occur between the two portions of the bowel that have been anastomosed or sewn together. This is a serious complication since the contents of the bowel leaking into the abdomen can result in an abdominal infection and peritonitis, resulting in vomiting abdominal pain , shock and high fever. Treatment will be to repair of the leak and antibiotic therapy.
Intestinal Obstruction
Intestinal obstruction may occur in several months or in several years after the procedure. This may be due to adhesion of the abdominal tissues or scarring. This may be treated conservatively with intravenous fluids and by resting the intestines. With no food for about two days, it may resolve itself. If this is not effective abdominal exploratory surgery may be done to resolve the obstruction.
Other Important Issues
Other important issues include diet, bowel control, ostomy care, if an ostomy was performed, emotional support and doctor's follow-up appointments. A dietitian will be able to help with diet, an ostomy nurse will help you with the education and care of the ostomy, and a support group will be helpful in adjusting to life after colon surgery.
