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Chapter: Medicine and surgery: Gastrointestinal system

Small bowel surgery - Investigations and procedures

Small bowel resection is normally followed by immediate end-to-end anastomosis as the small bowel has a plentiful blood supply, a stronger wall and a content with a lower bacterial count.

Small bowel surgery

 

Small bowel resection is normally followed by immediate end-to-end anastomosis as the small bowel has a plentiful blood supply, a stronger wall and a content with a lower bacterial count. Small to medium resections have little functional consequence as there is a relative functional reserve; however, massive resections may result in malabsorption.

 

·        Gastric hypersecretion is common postresection possibly due to loss of secretary inhibitory factors.

 

·        Nutritional consequences are severe when more than 75% of the bowel is resected.

·        Loss of jejunum affects all nutrients, loss of the terminal ileum affects absorption of bile salts and vitamin B12. Iron and folate are absorbed from the upper small bowel.

 

·        Severe diarrhoea causes electrolyte loss, hypertrophy of the mucosa occurs over a period of 2 years after which any residual diarrhoea is likely to be permanent.

 

Following small bowel surgery fluid and electrolytes must be monitored and corrected as required, fat-soluble vitamins should be supplemented.

 

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Medicine and surgery: Gastrointestinal system : Small bowel surgery - Investigations and procedures |


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