Diverticulitis. When Surgery Is Needed.
Diverticulitis is a potentially serious infection of the wall of the colon. It may first present as a mild episode of left sided abdominal pain, or it may present with a life threatening infection known as sepsis. When an emergency operation to remove the infected segment of colon is needed, a protective colostomy may be needed to temporarily divert the fecal flow (stool) away from the operative site.
While a colostomy may seem extreme to those unfamiliar with it, a colostomy is an important part of the skill set of the colon and rectal surgeon, also known as a proctologist, or coloproctologist.
The colon, especially the left side of the colon, is a high pressure zone which moves stool forward and then stores it for voluntary discharge at a convenient time. The colon can develop small outpouchings at areas of weakness in the wall. When this happens, patients are said to have diverticulosis, a common and harmless condition…unless one of these outpouchings begins to bleed, necessitating an emergency operation to remove the bleeding piece of colon.
Sometimes, diverticulosis can turn into diverticulitis when one of the outpouchings becomes inflamed. This usually causes abdominal pain. This can be accompanied by fever, chills and hypotension (low blood pressure). In severe cases, the colon wall can perforate, or rupture, and stool may be spilled into the abdomen, a potentially life threatening condition. Even without perforating, an abscess (a collection of pus) may accumulate next to the inflamed segment of colon. Often, these are surgical emergencies.
A Colectomy (colon resection). Why?
When your surgeon determines that an operation is needed on an emergency basis, it is performed at a hospital such as Cedars-SinaiMedicalCenter. As this is performed urgently, there is little or no time to prepare, or cleanse the colon. This means that at the time of surgery, the colon may be full of stool. The operation is known as a colectomy.
The concept behind the operation is straightforward, even to a non-physician; the diseased segment of bowel must be removed as a life saving procedure. It is known that attempting to reconnect the colon (after removing the disease) in acute diverticulitis may be dangerous. It may be subject to dehiscence; it may fall apart. The logic behind using a colostomy is that the flow of stool is diverted away from the operated segment, allowing the area to heal. The colostomy can be closed (reversed) at a later time when healing has occurred.
Colostomy. What Is It?
The colostomy is brought out as a small opening on the side of the abdomen. It is covered by a deodorizing bag. There is no odor associated with a colostomy while the bag is in place. The bag, when full, can be changed in privacy.
A specially trained ostomy nurse will be able to teach you about the colostomy bag and its use. You will learn about fitting of the bag, the changing of the bag, and skin care around the bag. The colostomy is usually reversed shortly after the abdominal operative site has healed.
Los AngelesColon and Rectal Surgical Associates.
Colon and rectal surgeons of Los Angeles Colon and Rectal Surgical Associates are board certified and trained in all aspects of diseases of the colon, rectum and anus. They have expertise in diseases requiring the use of a colostomy. Your consultation is confidential and informative. You may call (310)273-2310 to make an appointment. There is educational literature available on the office website.