Question

John Brown is a 72- year-old man (100kg) who has recently  returned to the general surgical war following a resection of part of his bowel. His past medical history includes smoking for 40years ( but not in the past 10 years ), hypertension, diabetes (type 2) that was diagnosed 5 years ago. His current medications includes ramipril 2.5mg and gliclazide 40mg twice daily. He also reports that he takes non-steroidal anti-inflammatory drugs (NSAIDs) regularly due to chronic back pain. Over all the surgery was uneventful although it was estimated that he sustained a 2- liter blood loss. He was transferred with 2 units of blood alongside other intravenous fluid. On return to the ward his condition appeared stable. He has two redivac drains in situ and there was minimal drainage noted in them. His vital signs were also within normal limits. Later that afternoon, however, the nursing staff noted that his urinary output had decreased to less 40ml/hr. They continued to monitor this for couple of hours and then informed the doctor when it showed no signs of improvement. Bloods were sent off to the laboratory as the doctor was concerned that John might be developing acute kidney injury (AKI).

Define the patient's disease process

Describe the patient's disease process

Clearly explain etiology of the disease process

Clearly explain the cause of the disease process

Thoroughly explain signs and symptoms of pathology

Answer 1

A gut resection is a medical procedure to expel any piece of the inside. This incorporates the small digestive tract, internal organ, or rectum. Specialists use it to treat sicknesses and blockages of the digestive organ (colon).

Inside infections and conditions can put your life in danger. They can likewise shield the colon or rectum from functioning as they should. This causes side effects like torment and distress.

Your primary care physician may suggest a gut resection for one of the accompanying reasons:

Malignant growth: The measure of gut he evacuates relies upon the size and area of the disease. The specialist will take out close by lymph hubs, as well.

Diverticulitis: You may require medical procedure for confusions, for example, extreme contamination or puncturing

Blockage: When your digestive tract gets blocked, food and fluid can't pass. This can remove the blood gracefully, making tissue pass on.

Extreme dying: If specialists can't stop a gut drain, they may need to expel that segment of the digestive tract.

Gut Resection Surgeries

Colon medical procedure is done in one of three different ways:

Open resection: A specialist makes one since quite a while ago cut on the gut. He'll utilize ordinary careful devices to take out a segment of the digestive system.

Laparoscopic resection: The specialist makes two to four little cuts (entry points) on the gut. He embeds a slender cylinder with a small camera into one cut. This is known as a laparoscope. It sends an image to a screen. The specialist utilizes it to see inside the midsection. He at that point passes little, uncommon careful instruments through different cuts to evacuate some portion of the digestive tract.

Robot-helped laparoscopic resection: In this medical procedure, the instruments are joined to robots. The specialist controls the robots to play out the medical procedure.

The kind of medical procedure you'll get relies upon your condition. The area and size of the infected or harmed colon are additionally factors. At times, your specialist may need to transform from a laparoscopic to open medical procedure during the strategy.

What Happens During a Bowel Resection?

This is a significant medical procedure. You'll have to look into a clinic. Upon the arrival of your medical procedure, you'll get general sedation. That implies you'll go into an oblivious, rest like state so you don't feel anything during medical procedure.

During the strategy, a specialist will disengage the internal organ from the encompassing organs and tissue. He'll cut and expel the harmed or ailing piece of the entrail. He'll reconnect the sound parts of the bargains with small staples or stitches.

In some inside resections, the specialist should do a colostomy. This makes an opening in the skin, or stoma, for dung to go into a sack. Your specialist will play out a colostomy if an issue may keep the two parts of the bargains from mending appropriately. A few stomas are impermanent. Following 6 to 12 weeks, you'll need a subsequent medical procedure.

Planning for Surgery

Prior to the medical procedure, you'll go into your specialist's office. You'll talk about your clinical history and survey what meds you're on. You'll additionally get tests, for example, a chest X-beam, electrocardiogram, and blood tests. This enables your specialist to design the technique. It likewise recognizes any issues that may influence the medical procedure.

In the days prior to your medical procedure, your primary care physician may instruct you to quit taking certain enhancements and drugs, similar to ibuprofen. He'll additionally disclose to you how to plan for the strategy. To clear the insides, you'll have to maintain a strategic distance from strong nourishments the day preceding medical procedure. Clear fluids, for example, stock and squeezed apple, are fine. You'll likewise take a diuretic.

The prior night and morning of your gut resection, you'll shower with a disinfectant wash. This can help forestall diseases.

Dangers

Likewise with all medical procedures, gut resections accompany certain dangers or potential entanglements. They include:

Contamination: Your careful injury can get tainted. You may likewise get a disease in the lungs (pneumonia) or urinary tract.

Injury: During the technique, the digestive organs, bladder, or veins close to the insides may get harmed.

Spillage: If the resection doesn't mend appropriately or gets tainted, the colon can spill. Specialists call this an anastomotic hole. It can prompt draining and a hazardous contamination. Call your primary care physician quickly on the off chance that you have any side effects, for example, stomach agony, fever, or a fast pulse.

Hernia: This can create because of the specialist cutting your stomach divider.

Scar tissue: As your digestive tract recuperates, scar tissue may shape. After some time, this may cause a blockage.

Recuperation

After the medical procedure, you'll remain in the clinic for around 2 to 4 days. Prescription will help facilitate the agony. Your medical caretaker or specialist will disclose how to think about your injury. On the off chance that you have a stoma, they'll tell you the best way to think about it.

Directly after the medical procedure, you'll have the option to drink liquids. You might have the option to eat strong nourishments the next day. Your specialist may suggest eating a low-fiber diet for about a month.

Recuperation from a laparoscopic medical procedure is quicker than with an open resection. You'll additionally have less torment and littler scars.

Following 1 to about fourteen days, you might have the option to return to a large portion of your ordinary daily practice, for example, strolling and working. Try not to attempt to lift anything more than 10 pounds or do serious exercise until you get your PCP's OK. It for the most part takes around a month and a half to recuperate completely.