Colorectal Surgery

Approximately 2 weeks ago, my grandmother had to undergo a resectioning of her decscending colon.  According to the surgeon, this procedure was performed in order to remove a benign tumor.  Prior to her surgery, my grandmother was an extremely active 70 year old woman and was in a fairly healthy condition for her age with the exception of two musculoskeletal surgeries and the placement of two cardiac stents.   She was admitted and a battery of diagnostic tests were performed.  Several diagnosese were give, from apendicitis to colitis all over the course of 3-4 weeks with the appropriate courses of treatment for each, but without success.  Finally, a colonoscopy was performed and it was determined that she did in fact have an obstructed colon and that a resectioning was needed.  After the resectioning, my grandmother did not recover as expected and she continued to have severe pain and infection.  An emergency colonoscopy was order and the gastroenterologist's findings was that there appeared to by some inflammation around the resected area of the colon along with an area that appeared to be necrotic.  With that, the surgeon reopened that origninal surgical site and removed an additional section of her colon and placed an external colostomy.  The surgeon also reported that her abdominal cavity was full of infection and that there was leakage from the colon.

My question is, "what could have caused this necrosis of her colon after resectioning" and "shouldn't the surgeon have reassured that there was an adequit  blood supply to the colon and that the colon was adequitly sutured by testing it prior to closing"?  

[Denise L. Johnson, M.D.]

Colon surgery , resection and anastomosis, has a small but real incidence of leaking at the suture line.

This is due to necrosis or loss of small vessel blood supply.  At the time of surgery, the surgeon will make sure that the suture line looks intact and has a good blood supply.  However, with advanced age, cardiac conditions and infections can cause the blood supply to be compromised.

Please discuss with the surgeon what he thinks your grandmothers prognosis is at this point.

Dr. J

[ccdh750]

Thank you for responding to my posting.  At this point, My grandmother in now having to undergo a third surgery to repair the colostomy that this surgeon placed.  All of the other consulting surgeon have all stated that this is a case that has gone terribly wrong.  An appropriate course of action will follow.  Thank you again for your input.

CCDH750