Injuries to the large and small bowel can result in extended hospital stays, disability, and even death. The evaluation of these cases is difficult because of the wide variety of fact patterns that can be presented, the numerous issues that must be considered in the analysis, and the reality that bowel injuries, no matter how serious, can occur in the absence of negligence. These cases cannot be ruled in or out until the complete medical chart has been reviewed by an experienced medical malpractice attorney and a highly qualified surgical expert.
Although a bowel perforation during surgery is not always due to medical malpractice, a delay in diagnosing a bowel perforation could be. Bowel injuries often appear with distinctive signs and symptoms during the early post-operative period, including pain, fever, tachycardia (rapid heartbeat), and tachypnea (rapid breathing). These signs, particularly when accompanied by failure to thrive, should alert treating practitioners that the patient could be suffering from a bowel injury. If the post-operative symptoms cannot be adequately explained, the standard of care requires careful evaluation of the patient, increased monitoring, and appropriate diagnostic testing.
Whether a patient suffers limited or substantial damages from a bowel injury depends on where the injury is located and how quickly it is diagnosed and treated. Small bowel contents contain much lower levels of bacteria than the contents of the large bowel, also called the colon. The leakage of bowel contents into the abdominal cavity usually results in peritonitis, inflammation of the lining of the abdomen, along with inflammation of the tissues of the bowel and other abdominal organs. Early detection of bowel injury is key to effective treatment because of the risk patients have of developing infections, suffering from septic shock, experiencing an intestinal fluid leak or developing peritonitis. The manners in which a surgeon may treat a perforation during or following the initial procedure include the following:
1) Surgical repair of the bowel during the operation. If the error is noticed before the surgery is over, the surgeon can fix the problem before closing the wound and take precautionary measures to reduce the risk of infection and complication. These measures include the use of precautionary antibiotics and ordering close monitoring of the patient during recovery.
2) Performing a colostomy to reroute the bowel. If revision surgery is needed to repair the damage caused by a perforated bowel, the surgeon may perform a colostomy to redirect the flow of intestinal fluids and waste. This could be reversed later after the patient has recovered, but in some cases, it is permanent.
3) Emergency surgery to repair organ damage. It is possible for inflammation or the rapid spread of infection to require emergency action in order to save the patient’s life.
Delay in diagnosis often results in development of severe inflammation and fragility of the bowel tissue that prevents the surgeon from performing a single, definitive repair. The most devastating consequences of unaddressed bowel perforation are the systemic complications. Patients can develop bacteremia, viable bacteria in the circulating blood, and go on to suffer septic shock, stroke, organ failure, and death.
The Thistle Law Firm is experienced in handling cases involving bowel injuries. If you or a family member suffered harm due to a bowel injury after a surgery, it may have been due to improper care or medical negligence after a surgery. The attorneys at The Thistle Law Firm are here to take your call and answer your questions at 215-568-6800.