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Ask Dr. D. Love Your Own Question
Dr. D. Love
Dr. D. Love, Doctor
Category: Medical
Satisfied Customers: 18533
Experience:  Family Physician for 10 years; Hospital Medical Director for 10 years.
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I had a perforated colon in September 2015 which resulted in

Customer Question

I had a perforated colon in September 2015 which resulted in an emergency surgery. That surgery did not require a colostomy. However after I was discharged from the hospital I returned to have a second emergency surgery as there was another leak. At that time I did get the colostomy. In December 2015 it was determined i could have the reversal surgery. I had the reversal and within a couple days of discharge I was back in the OR and I now have an ilostomy. My surgeon says that this at times happens. This does not seem normal and I am not sure which direction I should go now. Any assistance or advise would be greatly appreciated.
Submitted: 1 year ago.
Category: Medical
Expert:  Dr. D. Love replied 1 year ago.

Hello from JustAnswer.

I am sorry that you are having so many problems.

Yes, your surgeon is correct that this sometimes will happen.

Whether there are any alternatives beyond giving it more time to heal would depend upon the underlying condition that led to the perforation of the colon.

What underlying cause was determined to be the cause of the perforation?

Customer: replied 1 year ago.
Colitis was the underlying issue. Now I am being told that my intestines are so inflamed and I have formed a massive amount of adhesions from one surgery to the next, that this is a huge obstacle. I don't understand why the reversal was allowed to happen so quickly from the first surgery and then have all these issue to happen. Is there any easier process for next steps? It has been three weeks now that I have been home.
Expert:  Dr. D. Love replied 1 year ago.

It is unclear from this information why they would have reversed the surgery so quickly if there is such severe inflammation still present. It sounds like they may not have done a sufficient evaluation to assure that the inflammation was resolved.

However, from this point going forward, the usual approach in this situation would be to more aggressively treat the inflammation to promote healing. Many of the medicines used for treatment of colon inflammation are avoided immediately after surgery, as the medicines can also impair healing of the surgery. The medicines that would be used for inflammation also would vary according to the type and location of the inflammation. If the inflammation is affecting the entire length of the colon, then systemic medicine would be needed.

If you have not yet seen a Gastroenterologist for assessment and treatment of the underlying inflammation, that would be a reasonable next step. Further surgery would have a much better success rate once the inflammation is well treated.

Has the surgeon discussed a plan for management of the inflammation?

Customer: replied 1 year ago.
No, my surgeon was scheduled to leave the country on a Christmas vacation and I have been referred to another doctor, but of course treating me in the here and now issues.
Expert:  Dr. D. Love replied 1 year ago.

I interpret this wording to mean that this was not a referral to a Gastroenterologist. If this referral was to another surgeon that is covering his practice, then it would be appropriate to seek an appointment with a Gastroenterologist for management of the inflammation. This covering surgeon can make the referral or you can contact the Gastroenterologist's office directly. It also would be an option to ask your primary care physician for a referral, if necessary.

Is there any other information that would be helpful?

Expert:  Dr. D. Love replied 1 year ago.

Please let me know if I can provide any additional assistance.

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