Intraoperative Bowel Injuries
Bowel injuries during abdominal operations are dreadful complications. Without more information, they neither establish that there was nor that there was not deviation from standard of care. Most of these injuries are recognized and fixed during the initial operation but there are a small percentage of them that are missed during the initial operation and eventually become obvious, typically within 24-48 hours (typically) after the initial operation. Some of these injuries may be missed full-thickness enterotomies (i.e., an opening into the intestine). However, some are partial tears/injuries that do not “go all the way through” but, rather, eventually progress to full perforation over the subsequent days. Burn injuries (from cautery) are some of the most common missed or delayed presentation injuries; injuries may certainly also be caused by adhesiolysis performed by blunt or sharp dissection. The mechanism of injury may also be from shearing. Bowel shearing typically happens when a part of the bowel that is densely adherent (i.e., stuck) to something gets pulled, which causes some or all of the layers to rip.
Intraoperative bowel injuries medical expert witness specialties include general surgery, pediatric surgery, pathology, anesthesiology, gastroenterology, pediatric gastroenterology, radiology, forensic pathology, infectious disease, and pediatric infectious disease.