Complications of large bowel surgery

Early complications of large bowel surgery include:

• faecal contamination, caused by: - perforation prior to operation - faecal spillage during operation - postoperative leakage, for example anastomotic
• infection - large bowel surgery has always been associated with a high risk of post-operative infection which has now reduced because of the use of preoperative bowel cleansing and prophylactic antibiotics. When they occur, complications include: - wound infection - intraperitoneal abscess - generalised peritonitis
• damage to other organs, e.g. ureters, bladders, spleen
• stomal problems - retraction or sloughing

Late complications include:

• diarrhoea due to shortened bowel
• impotence due to division of parasympathetic nerves
• obstruction of the small bowel - adhesions, or tangling of the small bowel with ileostomy or colostomy