Post-Surgery Complications: When Intestines Emerge from Wounds

Surgical wound evisceration?

Hello doctor, I underwent laparoscopic surgery at the beginning of September.
A week later, after having my stitches removed at the hospital, I noticed abdominal pain shortly after returning home.
Upon inspection, I found that part of my intestine was protruding from the incision in the lower right abdomen.
When I returned to the hospital, the doctor was able to push the intestine back in, but did not clearly explain the reason for this occurrence.
Could you please explain to me why this happened?

chi, 40~49 year old female. Ask Date: 2019/10/01

Dr. Yang Zhichao reply Gastroenterology and Hepatology

Hello Ms.
Chi, please discuss this issue with your attending physician, as they are the surgeon in charge.
Thank you for your question.

Reply Date: 2019/10/01

More Info

Experiencing the emergence of intestines from a surgical wound, known as evisceration, is a serious complication that can occur after abdominal surgery, including laparoscopic procedures. This situation can be alarming and raises several important considerations regarding surgical technique, wound healing, and postoperative care.

Evisceration typically occurs when there is a failure of the surgical closure, which can be attributed to various factors. One common reason is inadequate suturing or closure of the abdominal wall, which may not provide sufficient support for the internal organs. This can happen if the tissue is weak or if there is excessive tension on the closure due to factors such as obesity, infection, or improper wound care. In your case, the fact that the intestines emerged a week after surgery suggests that the wound may not have healed properly or that the closure was compromised.

Another potential cause of evisceration is the presence of infection at the surgical site. An infected wound can lead to tissue breakdown and failure of the sutures, allowing the intestines to protrude. Signs of infection may include increased redness, swelling, warmth, and discharge from the wound. It is crucial to monitor for these symptoms post-surgery and to seek medical attention if they occur.

Additionally, factors such as increased intra-abdominal pressure due to heavy lifting, straining, or coughing can contribute to the risk of evisceration. Patients are often advised to avoid strenuous activities and to follow specific postoperative care instructions to minimize this risk. If you experienced any significant physical strain shortly after your surgery, it could have contributed to the issue.

Postoperative care is vital for ensuring proper healing. This includes keeping the surgical site clean and dry, following the surgeon's instructions regarding activity levels, and attending follow-up appointments for wound assessment. If you notice any unusual symptoms, such as increased pain, swelling, or changes in the appearance of the wound, it is essential to contact your healthcare provider immediately.

In your situation, since the surgeon was able to return the intestines to their proper place, it is crucial to follow up closely with your healthcare provider to monitor the healing process. They may recommend additional imaging studies or examinations to assess the integrity of the surgical site and to ensure that there are no underlying complications.

In conclusion, evisceration is a serious complication that can arise from various factors related to surgical technique, wound healing, and postoperative care. It is essential to maintain open communication with your healthcare provider, adhere to postoperative instructions, and report any concerning symptoms promptly. Understanding the reasons behind such complications can help you take proactive steps to ensure a smoother recovery and prevent future issues.

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