Fecalito - Surgical intervention

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When it's time to talk about stool, it's usually uncomfortable for people in general. However, in the surgical area these problems are usually seen at the gastrointestinal level, being the fecaloma or also fecalito as one of the most common but with regard to surgical interventions, it is very rare to see.


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When mentioning fecalito we should know that it is a problem that anyone can suffer, it is a problem at the digestive level where feces accumulate and therefore they solidify (thus being very hard to be expelled correctly). Fecaliths can also be known as fecalomas as I mentioned earlier and also by the name of coprolite, or also called as the famous stool stones.

The fecal problem can occur both at the rectal level and at the level of the intestines.

When the problem is at the level of the intestines, the small intestine and the large intestine can be compromised, and it is there that a surgical intervention by the health team will be needed to improve the pathological problem in the patient who suffers from it.

Surgical intervention

Laparotomy

In this case we find a female patient who enters the surgical area for presenting a digestive problem in the small intestine, to be more precise a fecal problem such as a fecaloma. To solve the problem, a surgical intervention was performed where the patient had a laparotomy.

`What is laparotomy?

It is an invasive surgical procedure where the abdominal cavity will be opened by means of several incisions made by the surgeon in order to explore the viscera and if it is necessary to solve at that moment the problem that can be found in the cavity.

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The surgical team must be trained to face the intervention, this time we can count on the surgeon and two of his medical students (whom we refer to as residents; R1 and R2) An anesthesiologist, an instrumented nurse and a nurse circulating (which in this case is me).



The surgical intervention begins as such after the anesthesia doctor has done his job correctly and the patient is already under general anesthesia, it is there where the rest of the team must start to act.


Already the operating room must be previously equipped with the necessary materials for the intervention. Here I will name some of them; probes (Foley and Nelaton) gauze and sterile gloves, sterile pads, 0.9% physiological solution. In the event of an emergency, medications such as adrenaline or also known as epinephrine are required.


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Those who are responsible for equipping the operating room correctly are both instrumentalist and circulating nurses.

The general surgeon will begin to make the incision after the aseptic and antiseptic measures have been correctly performed in the patient and the surgical fields have been placed (this is done to prevent the spread of pathogens and thus prevent infections).

The incision that will be made will be longitudinal. This incision is made throughout the midline, following the sagittal plane of the abdomen, the incision ascends to the xiphoid appendages and descends to the pubic symphysis. You go through various layers until you reach the organs. An incision should be made in the skin, subcutaneous cell tissue, muscle, peritoneum (parietal and visceral) until finally reaching the desired organ, in this case the small intestine.

At all times of the intervention it is necessary for the instrumentalist to provide the tools to the surgeon and his assistants so that the surgery is faster and more effective.

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The surgeon and having the desired organ in an exposed manner will begin to make constant pressure until the feces leave the anus and the problem of the fecalito can be solved. Finally, the suture will be performed, this will require the last surgical time known as synthesis, and finally the patient will be cured.


It is important within the surgical area to keep calm in situations of clean-contaminated interventions, since the minimum error can lead to contamination of the patient's abdominal cavity, which is why you should always act calmly despite the pressure that It may exist at the moment.

In spite of being an extremely simple intervention, it is important to maintain aseptic and antiseptic norms in order to avoid future complications in the patient, such as an infection. In the same way, after performing the surgical intervention, it is important to explain to the patient that they should keep absolute rest due to the type of incision that has been made, since if it is exerted too much pressure it can end in an evisceration; that is, the viscera (organs in the abdominal cavity) can go outside the body, making this a very serious complication.

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Everything you just read here has been my little experience in Surgical Medical matters II


The separator you just saw, is my authority.
The images you just saw are my authority.
The program I have used is called Paint tool sai


Thank you very much for reading, any comments and questions you have will be well received.

Nursing student - Artist - @arisita

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