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It is quite common to experience postoperative complications following any surgery, including abdominal hernia surgery, gallbladder surgery, belly button hernia surgery, etc. These complications occur immediately or a few days following the surgery. Being aware of these complications will help you be prepared and also take the proper measures to prevent them.
It can be caused by various factors, including:
0-1 Day
1-3 Days
3-7 Days
After One Week
Postoperative Morbidity
Postoperative morbidity in abdominal surgery is caused by infections. Though it is reduced by taking prophylactic antibiotics, multi-resistant organisms can present a significant challenge.
Wound Infection
Skin staphylococci can lead to wound infection within seven days following surgery, causing redness, pain, and slight discharge.
Cellulitis and Abscesses
They generally occur following bowel-related surgery within the first week, third week, or even after discharge. Antibiotics are used to treat cellulitis, whereas:
Gas Gangrene
It is caused by clostridium perfringens (a bacterium), which produces gas-releasing toxins that lead to tissue death.
Wound Sinus
A deep chronic abscess occurring after normal healing due to non-absorbable mesh or suture causes wound sinus. It requires surgical re-exploration to remove the mesh/suture.
Wound dehiscence is when the wound begins to open up either partially or completely along the sutures. It usually occurs within 7-10 days post-surgery and is often identified by serosanguinous discharge from the wound. It can be managed with a sterile dressing to the wound, opiate analgesia, fluid resuscitation, or re-suture under general anesthesia.
Large volumes of blood transfusion may exacerbate hemorrhage by consumption coagulopathy. Unrecognized bleeding diathesis or preoperative anticoagulants may also cause hemorrhage. It can be managed with:
Late postoperative hemorrhage is usually caused by the infection damaging the blood vessels at the surgery site. It requires infection treatment and surgical re-exploration.
It occurs between 1 and 15 years after surgery, causing a bulge in the abdominal wall near the previous wound. It is usually asymptomatic but causes pain during strangulation.
Risk factors of incisional hernia are:
Incisional hernia can be managed or prevented by using:
It is caused by:
UTI
It is an infection affecting any part of the urinary system, including kidneys, urethra, or bladder. It can be treated with antibiotics and fluid intake.
Urinary Retention
It is a condition characterized by difficulty emptying the bladder. It can be managed with sufficient analgesia or catheterization.
Acute Kidney Injury
It is the sudden damage or failure of kidneys caused by antibiotics, aorta surgery, obstructive jaundice, and severe or prolonged hypertension.
Risk factors of acute kidney injury are:
Mild cases of acute kidney injury can be treated with fluid restriction (until tubular function recovers) whereas, severe cases may require dialysis or hemofiltration (in which the function recovers gradually within weeks or months).
Nerve damage occurs during various procedures, including:
Injuries such as falls, nerve palsies, diathermy burns, and damage to diseased bones and joints may occur during positioning or transporting to the ward.
DVT and pulmonary embolism are the major causes of mortality and complications post-surgery.
DVT
It is a blood clot formed in the deep vein (usually in the legs), causing tenderness of the calf muscle, swollen legs, and increased warmth with calf pain on passive dorsiflexion of the foot.
Pulmonary Embolism
It occurs when a blood clot blocks one or more arteries in the lungs. It causes sudden dyspnea and cardiovascular collapse with pleuritic chest pain, pleural rub, confusion, breathlessness, and hemoptysis.
Atelectasis (alveolar collapse)
It occurs when airways in the lungs are obstructed by bronchial secretions. It causes mild tachypnea and tachycardia and slow recovery from surgery. It can be prevented by preoperative and postoperative physiotherapy.
Pneumonia
It is an infection of one or both lungs caused by microorganisms. It can be treated with physiotherapy and antibiotics.
Aspiration Pneumonitis
Patients who aspirate (inhale) gastric contents during surgery can develop pneumonitis or aspiration pneumonitis. It causes vomiting or regurgitation with rapid onset of breathlessness and wheezing. It can be prevented by crash induction technique and oral antacids or metoclopramide.
Acute Respiratory Distress Syndrome
It occurs when fluids collect in the lungs’ air sacs, thus causing rapid, shallow breathing and severe hypoxemia with scattered crepitation. It requires intensive care with medical ventilation.
Early Mechanical Obstruction
It can be caused by a trapped/twisted bowel loop or adhesions occurring around one-week post-surgery. It may require surgery or can be managed with nasogastric aspiration and IV fluid.
Delayed Return of Function
Anastomotic Leakage or Breakdown
Small leaks can cause localized abscesses with delayed bowel function recovery. It can be resolved with IV fluids and delayed oral intake. Otherwise, surgery may be needed.
Major Breakdown
It causes progressive sepsis and generalized peritonitis, which can be managed with antibiotics or may need surgery.
Late Mechanical Obstruction
It is caused by persistent adhesions, presenting isolated episodes of small bowel obstruction after months or years following surgery.
Contact us today at Far North Surgery if you are looking for an effective alternative to conventional open surgery. Our surgeon, Dr. Madhu Prasad, has years of experience and expertise in performing minimally invasive procedures that ensure a quick recovery and minimize complications.
