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Medical Forum / General / General / November 2007

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Colostomy for a bowel (sigmoid) obstruction?

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ileoman@hotmail.com - 21 Nov 2007 02:04 GMT
About 7 yrs ago, I had a sigmoid resection surgery (at about 10 cm
from the anus) becaus of cancer. Since then, I had several bowel
obstructions.

At the hospital, I generally had IV fluid, NG tube and pain killers,
and then discharged a few days later. However, about a year ago, the
emergency doctor gave me an ileostomy without my specific consent,
while my colorectal surgeon was out of town.

My colorectal surgeon, who operated on me 7 yrs ago, now tells me that
he has found harden surgery scar tissues at my sigmoid site that has
narrowed and may have caused my past blockages. He proposes to close
my ileostomy and open a colostomy. In his view, he cannot surgically
remove the scar tissues at the sigmoid site, and he cannot use stents
to open up my sigmoid narrow passage.

However, for the past few months, I have had the barium follow through
and enema x-rays from my stomach to my anus, and the fluid flowed OK
inside my small bowel and colon.

Now, I am not sure if I should accept my surgeon's surgery proposal to
have a colostomy because that is a big surgery, and I dont know if the
benefit, if any, would outweigh the sugery risks.

In my view, as my bowel obstruction comes about once a year, the
hospital may open my sigmoid passage through non-surgical means (e.g.,
pumping air).

About 3 weeks ago, I asked my surgeon to get a 2nd opinion from
another colorectal surgeon. But, he has yet to get back to me,
Howard McCollister - 26 Nov 2007 14:05 GMT
> About 7 yrs ago, I had a sigmoid resection surgery (at about 10 cm
> from the anus) becaus of cancer. Since then, I had several bowel
[quoted text clipped - 26 lines]
> About 3 weeks ago, I asked my surgeon to get a 2nd opinion from
> another colorectal surgeon. But, he has yet to get back to me,

All sounds pretty wierd to me. There is almost certainly more to this story
than we're getting here.

An obtruction at the place where your sigmoid colon was sewn back together
at 10 cm from the rectum should be pretty straightforward to diagnose with
either barium enema or colonoscopy, and if there's a stricture there, it
*might* be able to be opened with a hydrostatic balloon.

I can see an operation to look for the source of the obstructing adhesions.
I'm having a hard time, based on what you've written above, in understanding
why a colostomy would be necessary if there's no obstructing cancer.

You don't need your surgeon's permission to get a second opinion, and I
*strongly* recommend that you get your records from the hospital where your
operations were done, find another surgeon, and go see him/her. Don't rely
on your surgeon to do that - you're the one with the doubts and questions,
not him.

HMc

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