Medicine describes the bursting open of the surgical wound after an open abdominal operation as a bursting stomach. Poor wound healing, obesity, and physical exertion are potential causes of bulging.
What is a square belly?
Abdomen is a complication after open laparotomy. A laparotomy is a surgical procedure that opens the abdominal wall in the abdominal area. The surgical wound is then sewn up. The bulge occurs when the suture bursts open and the edges of the wound gape apart. This condition is known by the technical term suture dehiscence.
Internal parts of the abdominal cavity protrude, which means they push out of the body. Organs, parts of the intestine and the omentum are potentially affected. The mesh is a layer of tissue that encloses the two stomach mesentery of humans. The prolapse of the intestines is also known as prolapse or prolapsus. See polyhobbies for Meanings of AIDS.
Medicine distinguishes between two different forms of bulging: Experts speak of a complete or open bulging when all the seams on the abdomen burst open. On the other hand, in the case of an incomplete or subcutaneous full abdomen, the outer skin suture remains intact while the supporting suture tears.
There can be a variety of causes for bulging. A bruise (hematoma) can favor the development of the bulging abdomen. A seroma can also lead to a full belly. A seroma is a pseudocyst that contains blood serum or lymph fluid. The seroma can develop on the surgical wound if it has already closed superficially.
Another potential cause of a swollen abdomen is the use of an unsuitable suturing technique when closing the wound. A strong abdominal pressure, for example when a strong cough creates pressure on the abdominal cavity, can also cause the swollen abdomen. Likewise, excessive pressure due to early mobilization is a possible trigger of the swollen stomach; with rapid mobilization, overweight patients in particular are at increased risk of suffering from a swollen abdomen.
Regardless, obesity is generally a risk factor for complications after surgery. It also potentially weakens and overstretches the abdominal wall, which also increases the likelihood of a full belly. Above all, an excess of subcutaneous fatty tissue favors the development of a full belly. Furthermore, the full belly can be caused by a metabolic disorder; this has a negative effect on the healing of the wound.
Reduced wound healing can also have its origin in cancer and/or associated chemotherapy or radiation therapy, diabetes, infections, liver or kidney insufficiency.
Symptoms, Ailments & Signs
The bulging abdomen usually manifests itself four to six days after the operation. Patients may feel increased pain at and around the wound due to the swollen abdomen. The externally visible, gaping edges of the wound are symptomatic of the complete or open abdominal cavity. The open space belly usually attracts attention during the standard surgical suture control.
A corresponding check-up can also detect an incomplete or subcutaneous bulge. However, in the case of a subcutaneous full abdomen, the external suture is intact, making detection difficult. A possible indication of the subcutaneous bursting provides, for example, the escape of clear fluid from the wound, which cannot be stopped. The discharge of the fluid is caused by an infection of the surgical wound, which in turn leads to increased blood flow to the affected area.
Diagnosis & course of disease
If there is a suspicion of a subcutaneous bulge, there is a need for more precise diagnostics, for which imaging methods are used. In addition, examinations using ultrasound and/or computer tomography (CT) can be considered. It is very important to discover the place belly as quickly as possible.
The reopened wound offers an open door to invaders such as bacteria and viruses and can lead to infection of the surgical wound. Furthermore, organs, parts of the intestines and the omentum can prolapse and push out between the gaping edges of the wound. This can lead to additional complications and pain.
Those affected usually suffer from relatively severe pain in the wound after the operation. This pain can also spread to other regions of the body and thus lead to pain in the back or flanks. This significantly reduces and restricts the quality of life of those affected.
Furthermore, if left untreated, the wound itself can become inflamed and infected. Fluid can also escape from the wound that cannot be staunched. Increased blood flow to the wound itself can also occur. In the worst case, bleeding or blood poisoning can occur. The person concerned can eventually die from this.
The treatment of the swollen abdomen is usually carried out by means of another minor intervention. This can accelerate wound healing so that no further complications arise. However, scars from the surgical procedure may remain or adhesions may occur. The life expectancy of the patient is not affected if the treatment is successful. Furthermore, there are no further complications after the complete covering.
When should you go to the doctor?
A bulging stomach must always be treated by a doctor. This disease does not heal itself and usually also leads to the death of the affected person if the bulging stomach is not treated in time. Only early diagnosis and treatment can prevent further complications. A doctor should usually be consulted if a wound causes severe pain and tearing of the wound. In most cases, however, the swollen abdomen is already noticeable during the check-up after the operation, so that it can be treated quickly. Furthermore, leakage of fluid from the wound can also indicate a bursting abdomen and should be examined by a doctor immediately.
The diagnosis and treatment of this disease is carried out directly in the hospital, so that the person affected usually does not have to visit another doctor. With early diagnosis and treatment, the course of the disease is positive and the life expectancy of the patient is not negatively affected.
Treatment & Therapy
In most cases, the treatment of the abdominal cavity is surgical. The surgical procedure enables the abdomen to be checked in order to rule out other causes or damage. Only then does the surgeon refresh the edges of the wound so that the tissue can grow together. The new sutures often not only replace the old, burst wound suture. Additional sutures through tissue further from the surgical wound can reduce pressure and tension on the suture itself.
After the abdominal wall has been closed, an abdominal belt or girdle can offer additional protection against a renewed swollen stomach or other complications. In rarer cases, the disease becomes chronic and leads to what is known as an incisional hernia. The scarred tissue tears apart and with this opening forms the hernial orifice through which a pouch-shaped bulge (within the abdomen, since the abdominal wall is held together by the superficial suture) of abdominal wall tissue can protrude as a hernial sac.
Individual intestinal loops, organs such as ovaries or other bodily components can move into the hernial sac. A possible consequence of the chronic swollen abdomen are adhesions, which complicate the treatment. The incisional hernia may enlarge over time, making the surgery less likely to be successful. For the treatment of chronic bulging, surgical treatment is usually recommended after six months or a year. However, the exact point in time may vary, as individual factors are included in the planning of the operation.
Elastic abdominal bandages are often used after laparotomy to prevent abdominal distension. They reduce the stress on the wound sutures and counteract the internal pressure of the abdomen to prevent internal organ prolapse.
The specialist can now carry out the treatment after a bulging stomach according to a specific scheme. Then it is guaranteed that a patient does not have any further difficulties. First, the inspection of the abdominal cavity is important to rule out causal causes. After that, the doctors can take care of the actual treatment. This can be done, among other things, by refreshing the edges of the wound. Good doctors are very competent in this regard.
Thereafter, additional stitches that are passed through and removed from the wound edge will be used. These can be considered as a successful treatment method. As a result, a renewed abdominal wall closure can be considered. In this way, it is quite possible to alleviate this clinical picture or to eliminate it completely. An elastic abdominal bandage or bodice after the operation will help ensure that the clinical picture heals well and no longer occurs.
In any case, a patient should consult the professionals in the field. In this way, bad manifestations of the swollen belly can be alleviated very well. The recognized therapies are still used today. This is positive for the patients who have been diagnosed with this clinical picture. In large clinics it is possible for you to discuss all necessary therapies with the doctors.
You can do that yourself
If a bulge occurs, an ambulance must be called immediately. The bursting of a wound in the abdominal area represents a medical emergency, which must first be treated by an emergency doctor and then treated further in the hospital. Therefore, the most important self-help measure is to alert the emergency services immediately.
Before medical help arrives, the victim must be given first aid. In order to prevent parts of the bowel and organs from prolapsing, the affected person must be placed in a still position. Depending on the severity of the injury, the abdomen may be bandaged with a cloth or bandage. The injured person must be calmed down and kept quiet until the emergency doctor arrives. The doctor must be informed about the circumstances of the bulging stomach (e.g. complications after an operation or an accident in the household). Strict rest is required after the hospital stay. A renewed bursting of the wound could permanently damage the tissue and must therefore be avoided at all costs.
An elastic waist bandage can prevent a full stomach. If the patient is overweight, he should lose the excess weight immediately after recovery to facilitate future operations and improve overall physical and mental health.