When Abdominal Surgery Goes Wrong
When abdominal surgery goes wrong the damage may be hidden for months or years. After the surgeon cuts through the skin on the abdomen, and the fatty tissue just under the skin, the doctor cuts into a structure called the peritoneum.
The peritoneum is the abdomen's protective inner lining. The peritoneum completely surrounds the collection of organs in the abdomen: stomach, duodenum, intestines, liver, pancreas, gallbladder, and appendix. In order to operate on any of those organs, the peritoneum has to be "entered".
Sometimes during an abdominal operation an artery will be cut, and blood will spill out into the lining. Other times, a surgeon may "nick" or cut the tubes that pass bile fluid from the gallbladder, or digestive fluid from the pancreas. Human waste from the intestines or pus from an infected appendix can spill into the peritoneum if a surgeon mistakenly cuts into those organs.
Patients may ask, "If the doctor cleans up the spill in the peritoneum, what's the problem?" The problem is that no matter how hard the surgeon tries to clean up an accidental spill of blood, bile, digestive fluid, pus or human waste from the peritoneum, the body reacts by forming fibrous scar tissue in the peritoneum.
The fibrous scar tissue begins to form inside the peritoneum within days after the surgery. The scar tissue can and often does attach in more than one place inside the peritoneum, pulling and tugging on the abdominal organs, or even making a band around the intestines that blocks the flow of bowel contents. Some attribute 60% to 70% of small bowel obstructions to adhesions after abdominal surgery.
Bowel obstruction is a life-threatening complication requiring surgery to "free-up" the bowel. The additional surgery necessary to save the patient's life from the after-effects of adhesions causes additional adhesions, and the increased risk of additional life threatening adhesions.
Adhesions, and surgery to treat adhesions, can be a vicious cycle for patients. Formation of adhesions is one of the most serious side effects of a surgical mishap during an abdominal operation.