Najczęstsze powikłania po operacji ropnia jamy brzusznej lub przestrzeni zaotrzewnowej
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Najczęstsze powikłania po operacji ropnia jamy brzusznej lub przestrzeni zaotrzewnowej

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Operacja ropnia jamy brzusznej lub przestrzeni zaotrzewnowej wykonywana jest w znieczuleniu ogólnym. Jak każdy zabieg chirurgiczny może wywołać powikłania, na który wpływ mają zły stan ogólny pacjenta, wyniszczenie organizmu, zaawansowana choroba nowotworowa, otyłość, cukrzyca, zły stan uzębienia, nagły tryb operacji, konieczność reoperacji, jak również choroby współistniejące, m.in. kardiologiczne, wątroby czy płuc.

Z uwagi na to, że w leczeniu ropnia konieczne będzie zastosowanie leczenia chirurgicznego, ale również antybiotykoterapii, w procesie leczenia może dojść do powstania kolejnego ropnia w rejonie miejsca operowanego bądź innego rejonu w organizmie.

Powikłania po operacji ropnia jamy brzusznej lub przestrzeni zaotrzewnowej dzielą się na powikłania ogólne, specjalne oraz tzw. niechirurgiczne.

Powikłania ogólne po operacji jamy brzusznej lub przestrzeni zaotrzewnowej

Wśród powikłań ogólnych wymienia się m.in. krwawienie pooperacyjne lub powstanie krwiaka, wówczas niezbędna zazwyczaj jest reoperacja. Ponadto może również dojść do wewnątrzbrzusznego zakażenia rany pooperacyjnej, do którego dochodzi najczęściej w wyniku obecności bakterii – przyczyny ropnia lub uwalnianych do pola operacyjnego bakterii kałowych, które są obecne wewnątrz jelit.

Powikłaniem ogólnym są również m.in. wydłużony czas gojenia rany, na który wpływa również obecność infekcji, rozejście rany pooperacyjnej – podczas którego dochodzi do wydostania się jelit na zewnątrz jamy brzusznej, powstanie przepukliny bądź tzw. keloidu, czyli przerosłej blizny.

Podczas przecinania powłok jamy brzusznej może również dojść do uszkodzenia nerwów, które mogą objawiać się przeczulicą lub niedoczulicą skóry. Na skutek tego rodzaju operacji i stosowanych środków dezynfekcyjnych lub prądu elektrycznego (noża elektrycznego) może również dojść do uszkodzenia tkanek miękkich i skóry. U tej grupy pacjentów obserwuje się również reakcję alergiczną na leki, środki znieczulające, krew i preparaty krwi, która objawia się najczęściej pokrzywką, swędzeniem, dusznościami, drgawkami bądź nawet zatrzymaniem akcji serca. Niekiedy operacja ropnia jamy brzusznej może być przyczyną zakażenia wirusem HIV lub zapalenia wątroby.

Powikłania specjalne po operacji ropnia jamy brzusznej lub przestrzeni zaotrzewnowej

Do powikłań specjalnych, u pacjentów po tego rodzaju operacji, należą m.in. przetoka jelitowa, żółciowa, trzustkowa lub moczowa. W wyniku infekcji i występującego nacieku zapalnego wzrasta również ryzyko uszkodzenia ściany sąsiadujących narządów i wycieku treści z przewodu pokarmowego lub moczowego.

Operacja ropnia jamy brzusznej lub przestrzeni zaotrzewnowej wykonywana jest w znieczuleniu ogólnym. Jak każdy zabieg chirurgiczny może wywołać powikłania, na który wpływ ma zły stan ogólny pacjenta, wyniszczenie organizmu, zaawansowana choroba nowotworowa, otyłość, cukrzyca, zły stan uzębienia, nagły tryb operacji, konieczność reoperacji, jak również choroby współistniejące, m.in. kardiologiczne, wątroby czy płuc. Z uwagi na to, że w leczeniu ropnia konieczne będzie zastosowanie leczenia chirurgicznego, ale również antybiotykoterapii, w procesie leczenia może dojść do powstania kolejnego ropnia w rejonie miejsca operowanego bądź innego rejonu w organizmie. Powikłania po operacji ropnia jamy brzusznej lub przestrzeni zaotrzewnowej dzielą się na powikłania ogólne, specjalne oraz tzw. niechirurgiczne. Powikłania ogólne po operacji jamy brzusznej lub przestrzeni zaotrzewnowej Wśród powikłań ogólnych wymienia się m.in. krwawienie pooperacyjne lub powstanie krwiaka, wówczas niezbędna zazwyczaj jest reoperacja. Ponadto może również dojść do wewnątrzbrzusznego zakażenia rany pooperacyjnej, do którego dochodzi najczęściej w wyniku obecności bakterii – przyczyny ropnia lub uwalnianych do pola operacyjnego bakterii kałowych, które są obecne wewnątrz jelit. Powikłaniem ogólnym są również m.in. wydłużony czas gojenia rany, na który wpływa również obecność infekcji, rozejście rany pooperacyjnej – podczas którego dochodzi do wydostania się jelit na zewnątrz jamy brzusznej, powstanie przepukliny bądź tzw. keloidu, czyli przerosłej blizny. Podczas przecinania powłok jamy brzusznej może również dojść do uszkodzenia nerwów, które mogą objawiać się przeczulicą lub niedoczulicą skóry. Na skutek tego rodzaju operacji i stosowanych środków dezynfekcyjnych lub prądu elektrycznego (noża elektrycznego) może również dojść do uszkodzenia tkanek miękkich i skóry. U tej grupy pacjentów obserwuje się również reakcję alergiczną na leki, środki znieczulające, krew i preparaty krwi, która objawia się najczęściej pokrzywką, swędzeniem, dusznościami, drgawkami, bądź nawet zatrzymaniem akcji serca. Niekiedy operacja ropnia jamy brzusznej może być przyczyną zakażenia wirusem HIV lub zapalenia wątroby. Powikłania specjalne po operacji ropnia jamy brzusznej lub przestrzeni zaotrzewnowej Do powikłań specjalnych, u pacjentów po tego rodzaju operacji, należą m.in. przetoka jelitowa, żółciowa, trzustkowa lub moczowa. W wyniku infekcji i występującego nacieku zapalnego wzrasta również ryzyko uszkodzenia ściany sąsiadujących narządów i wycieku treści z przewodu pokarmowego lub moczowego. Może również dojść do nieszczelności zespolenia wytworzonego podczas odtwarzania ciągłości przewodu pokarmowego (dzieje się tak najczęściej w przypadku zabiegów resekcji jelita), wytworzenia pooperacyjnych zrostów jelitowych (które mogą być przyczyną niedrożności przewodu pokarmowego bądź mogą wywołać wciągnięcie sztucznego odbytu do jamy brzusznej). W konsekwencji operacji ropnia, szczególnie u pacjentów otyłych, w zaawansowanym stopniu choroby, może również dojść do uszkodzenia innych narządów, w tym innego odcinka jelita, śledziony, wątroby, moczowodu, nerwów, naczyń krwionośnych, pęcherza czy macicy. Ryzyko to wzrasta również w przypadku chorych po przebytych zabiegach operacyjnych w obrębie jamy brzusznej, stanach zapalnych w jamie brzusznej, wystąpienia dużego nacieku zapalnego czy infekcji. Przedostanie się bakterii do krwi podczas tego zabiegu może spowodować również posocznicę czy wstrząs septyczny. Pomimo operacji może również dojść do powstania ropnia w narządach odległych. Niekiedy u pacjentów po tego rodzaju zabiegu dochodzi do niezwykle groźnego zarówno dla zdrowia, jak i życia - zakażenia protezy naczyniowej, w leczeniu której niezbędne będą antybiotykoterapia bądź kolejny zabieg naczyniowy. Niechirurgiczne powikłania operacji ropnia jamy brzusznej lub przestrzeni zaotrzewnowej Do wystąpienia niechirurgicznych powikłań po operacji ropnia jamy brzusznej lub przestrzeni zaotrzewnowej przyczyniają się stan ogólny pacjenta oraz choroby towarzyszące, takie jak zawał serca, zakrzepica żył głębokich i powierzchownych, zator tętnicy płucnej, udar mózgu, niewydolność serca, niewydolność oddechowa czy inne infekcje. Dlatego aby zminimalizować ich wystąpienie, tak ważne jest odpowiednie, specjalistyczne przygotowanie pacjenta przed operacją. Źródło: Górnośląskie Centrum Medyczne Przeczytaj także: Lekarze z NIO w Gliwicach uratowali oskalpowaną pacjentkę

Może również dojść do nieszczelności zespolenia wytworzonego podczas odtwarzania ciągłości przewodu pokarmowego (dzieje się tak najczęściej w przypadku zabiegów resekcji jelita), wytworzenia pooperacyjnych zrostów jelitowych (które mogą być przyczyną niedrożności przewodu pokarmowego bądź mogą wywołać wciągnięcie sztucznego odbytu do jamy brzusznej).

W konsekwencji operacji ropnia, szczególnie u pacjentów otyłych, w zaawansowanym stopniu choroby, może również dojść do uszkodzenia innych narządów, w tym innego odcinka jelita, śledziony, wątroby, moczowodu, nerwów, naczyń krwionośnych, pęcherza czy macicy. Ryzyko to wzrasta również w przypadku chorych po przebytych zabiegach operacyjnych w obrębie jamy brzusznej, stanach zapalnych w jamie brzusznej, wystąpienia dużego nacieku zapalnego czy infekcji.

Przedostanie się bakterii do krwi podczas tego zabiegu może spowodować również posocznicę czy wstrząs septyczny. Pomimo operacji może również dojść do powstania ropnia w narządach odległych.

Niekiedy u pacjentów po tego rodzaju zabiegu dochodzi do niezwykle groźnego zarówno dla zdrowia, jak i życia – zakażenia protezy naczyniowej, w leczeniu której niezbędne będą antybiotykoterapia bądź kolejny zabieg naczyniowy.

Niechirurgiczne powikłania operacji ropnia jamy brzusznej lub przestrzeni zaotrzewnowej

Do wystąpienia niechirurgicznych powikłań po operacji ropnia jamy brzusznej lub przestrzeni zaotrzewnowej przyczyniają się stan ogólny pacjenta oraz choroby towarzyszące, takie jak zawał serca, zakrzepica żył głębokich i powierzchownych, zator tętnicy płucnej, udar mózgu, niewydolność serca, niewydolność oddechowa czy inne infekcje. Dlatego aby zminimalizować ich wystąpienie, tak ważne jest odpowiednie, specjalistyczne przygotowanie pacjenta przed operacją.

Źródło: Górnośląskie Centrum Medyczne

Przeczytaj także: Lekarze z NIO w Gliwicach uratowali oskalpowaną pacjentkę

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