Gen Surg: Bowel Perf - EDIT

Hey, I added this late. I realize. But hey surgery schedule is crazy.  Anyhow remember that gen surg is all about bowel. And there are lots of bowel surgeries. Why wouldn't there be being that your abdomen is full of it. If you want to know what it feels like imagine a rope of warm Jello and it is the thickness of your eyelid.  Go ahead a just try to hold it... good luck.  And you can totally feel the poo move through it, though the bowel doesn't like to be touched so it generally stops moving the poo when you touch it. Medically, whenever the bowel is touched there is a huge possibility of something called 'adhesions.'  Adhesions are tiny threads of tissue that are kinda like scar tissue that are very strong and can cause bowel obstruction and chronic pain. Adhesions are the #1 most common side effect of any abdominal surgery.

 You should also know that there are tiny 'tags' of fat that hang off the bowel. This is true for everyone, but the more fat that a person stores the more 'tags' there are on the bowel. These tags are the most variable area-- and function for a little bit of protection for those easy to rip bowels.

Lastly, the bowel is divided into different parts. Small intestine: duodenum, jejunem, and Ileum.  Large intestine: colon, sigmoid, rectum. The small intestine does most of the absorption. The large intestine absorbs mostly water. There is lots of bacteria in your bowel, but the most importantest are in the colon because they can make vitamins like B12 and they make gas when they breakdown (cough cough farts).

Anyhow, these pictures are of a bowel perforation, but not via trauma or other surgeons. It was from straining too hard when he POOPED. Yeah, bet you'll never think about pooping the same way. haha. ah, the terrors of life. :)  Anyhow, Bowel perforation is a big deal for a bunch of reasons. 

•  The first is it is leaking all of the digestive materials into your abdomen = gross.  Bowel perforations when you open the belly don't just smell like ordinary poo (ordinary poo goes through the colon which dries it out and all the nutrients are already gone). It smells unlike anything you've ever smelt before. And its awful.   
• Next, all the bacteria in our food plus the bacteria that helps us digest our food leaks into the bowel. Causing fever, infection, sometimes abscesses, or other major problems. 
• Lastly it won't heal itself. So it can be life-threatening. 

So...  this hole is in the colon. You can see in the picture to the right, i put the tools pointing at the hole.  You can also see the appendix dangling off the left part. The green above the hole means that the bowel contents (the poop) has already been in the abdomen long enough to stain the outside of the bowel. 

Why is it green?  Green is the color of bile. Bile is made in the liver and stored in the gall bladder. Bile helps us digest fats. As the poo material goes through the bowel different enzymes are added until eventually it breaksdown or gets reabsorbed to become brown. Ta duh! Lesson of the day.

Check out this close up of the perforation....