Abdominal Surgery Postoperative Complications

Surgery
Surgeons operating on a patient (Image: Keith Brofsky/Photodisc/Getty Images)

Any patient undergoing a surgical procedure is at risk for developing complications afterward, including bleeding, infection, breathing problems and developing blood clots in the legs that can travel to the lungs. The likelihood of developing postoperative complications depends on the age and general health of the patient, the type of anesthesia, surgical site and urgency of the procedure. Abdominal procedures, including gallbladder removal, appendectomy and bowel surgery, may cause a variety of postoperative complications related to the surgical site.

Pulmonary Complications

Pulmonary or lung complications, including atelectasis, pneumonia, respiratory failure, spasm of the breathing tubes or exacerbation of preexisting conditions, may occur after many types of surgical procedures. However, procedures involving the abdomen, chest or aorta carry the highest risk, according to Gerald Smetana, M.D., in a report published in the November 2009 issue of "Cleveland Clinic Journal of Medicine." Upper abdominal procedures, such as gallbladder removals, result in more pulmonary complications than gynecological surgeries.

Intestinal Obstruction

A bowel obstruction prevents the intestines from working properly, causing distention, vomiting, nausea, abdominal pain and cramping. Abdominal surgery may cause the small bowel to become paralyzed during the early postoperative period, a condition called paralytic ileus, according to MedlinePlus. Treatment includes walking and sometimes inserting a nasogastric tube to rest the bowel. Adhesions or scar tissue may form inside the body after abdominal surgery, causing a mechanical bowel obstruction. This condition blocks the digestive process and may require surgical correction.

Urinary Retention

Postoperative urinary retention, caused by spasms of the bladder sphincter, occurs most often after lower abdominal, rectal, anal or vaginal procedures, according to Sandra M. Nettina, M.S.N., in the 2010 edition of the “Lippincott Manual of Nursing Practice." Epidural or spinal anesthesia increases the risk of urinary retention. Men are more likely to develop retention, because the length of the urethra increases the resistance to urine flow. Catheterization may be necessary if the bladder becomes distended.

Wound Dehiscence

Wound dehiscence, a failure of the sutures, may occur between five and eight days after abdominal surgery, according to Nettina. This emergency situation may be caused by excessive stress on the wound from coughing, hiccups, vomiting or distention; inadequate or tight sutures; wound infection; diabetes; poor nutrition or hematoma. The patient complains of feeling the wound may open and suddenly drain fluid. Dehiscence of an intestinal wound can progress to evisceration, a condition in which the intestines protrude through the opened wound.

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