Life-Saving Emergency Gastrointestinal Surgery at Bombay Gastro & Cancer Institute, Bathinda
A 52-year-old morbidly obese female was brought to the emergency department with severe abdominal pain, persistent vomiting, high-grade sepsis, and acute kidney injury. A CT scan performed before admission had been reported as intestinal obstruction.
On examination, she was critically ill with diffuse abdominal tenderness, guarding, and signs of generalized peritonitis, raising strong suspicion of bowel ischemia. Owing to her rapidly deteriorating condition, she was immediately taken to the operating theatre for emergency surgery.
A Rare and Devastating Intraoperative Finding
The procedure was initiated with diagnostic laparoscopy by Dr. Raman Garg, Consultant Surgical Gastroenterologist, Advanced GI, Laparoscopic & HPB Surgeon at Bombay Gastro & Cancer Institute, Bathinda. Extensive gangrene of the small intestine was identified, necessitating immediate conversion to emergency exploratory laparotomy.
Intraoperatively, almost the entire small intestine was found to be gangrenous. Only approximately 12 cm of jejunum distal to the duodenojejunal (DJ) flexure and 15 cm of terminal ileum proximal to the ileocecal junction remained viable.
All non-viable bowel was resected while preserving every possible segment of healthy intestine. A primary jejunoileal anastomosis was then performed to restore intestinal continuity.
An Unexpectedly Excellent Recovery
Given the extensive bowel loss, the patient was expected to develop severe Short Bowel Syndrome, with risks of chronic diarrhea, dehydration, electrolyte imbalance, malnutrition, and prolonged dependence on parenteral nutritional support.
Remarkably, her recovery was far better than anticipated.
- Sepsis resolved completely.
- Acute kidney injury recovered.
- Oral feeding was gradually resumed.
- No major postoperative complications occurred.
- Discharged in satisfactory condition on the 8th postoperative day.
Two-Month Follow-Up
At two months after surgery, the patient continued to make an exceptional recovery.
- Taking a normal oral diet.
- No dehydration.
- No electrolyte imbalance.
- No significant nutritional deficiency.
- No clinically significant Short Bowel Syndrome.
- Returned to normal daily activities.
This represents an outstanding functional outcome despite near-total small bowel resection.
Why This Case Is Important
Near-total gangrene of the small intestine is one of the most catastrophic abdominal surgical emergencies and is associated with a very high risk of mortality. Patients requiring extensive bowel resection frequently develop Short Bowel Syndrome, often requiring long-term nutritional support and prolonged hospitalization.
This case demonstrates that early diagnosis, timely emergency surgery, meticulous preservation of viable bowel, and expert postoperative care can result in excellent outcomes, even in patients with extremely extensive intestinal gangrene.
It also highlights Dr. Raman Garg's expertise in managing complex gastrointestinal emergencies, bowel ischemia, intestinal obstruction, perforation peritonitis, emergency bowel resection, and advanced gastrointestinal surgery.
Advanced Emergency Gastrointestinal Surgery by Dr. Raman Garg
Dr. Raman Garg is a leading Surgical Gastroenterologist in Bathinda, providing comprehensive treatment for diseases of the small intestine, colon, rectum, stomach, liver, gallbladder, bile ducts, pancreas, spleen, and gastrointestinal cancers. His expertise includes emergency abdominal surgery, intestinal obstruction, bowel ischemia, colorectal surgery, hepatopancreatobiliary (HPB) surgery, advanced laparoscopic surgery, and complex gastrointestinal procedures.
Patients from Bathinda, Punjab, Haryana, Rajasthan, and neighbouring states seek his expertise for both routine and highly complex gastrointestinal surgical conditions.
Patient: 52-year-old Female
Diagnosis: Near-Total Small Bowel Gangrene with Intestinal Obstruction, Sepsis, and Acute Kidney Injury
Procedure Performed: Diagnostic Laparoscopy, Emergency Exploratory Laparotomy, Resection of Gangrenous Small Bowel, and Primary Jejunoileal Anastomosis
Operating Surgeon: Dr. Raman Garg, Surgical Gastroenterologist, Advanced GI, Laparoscopic & HPB Surgeon, Bombay Gastro & Cancer Institute, Bathinda
Outcome: Successful emergency surgery with discharge on the 8th postoperative day. At two-month follow-up, the patient remained clinically well, tolerating a normal diet without significant short bowel syndrome, dehydration, electrolyte imbalance, or nutritional deficiency.
About Dr. Raman Garg
Dr. Raman Garg is a Consultant Surgical Gastroenterologist, Advanced GI, Laparoscopic and HPB Surgeon at Bombay Gastro & Cancer Institute, Bathinda. He specializes in gastrointestinal cancer surgery, liver, pancreas and bile duct surgery, colorectal surgery, hernia surgery, upper GI surgery, emergency abdominal surgery, and advanced minimally invasive procedures.
Patient identity has been withheld to maintain confidentiality. This case is shared for educational purposes with appropriate consent and privacy safeguards.
