Early post-operative endoscopy of the operated intestine

Endoscopy in the early post-operative stage after an intestinal operation is seldom indicated, in contrast to control endoscopy carried out at a later stage. Experiments with animals show that endoscopy of intestinal anastomoses may be performed as early as 24 hours after an operation, if carried out carefully by an experienced endoscopist. During this early post-operative period, endoscopy is indicated only when complications arise. The most important application is the endoscopic insertion of an intestinal tube in cases of post-operative ileus. However, coloscopic suction in meteorism of the colon, and the introduction of tubes through swollen anastomoses are also possible. Bleeding of an anastomosis in the early post-operative stage is rare, whereas bleeding due to teleangiectatic granulomas in the later post-operative stage is more common. Both cases are indications for endoscopic hemostasis. Nevertheless, it must be emphasized that intestinal endoscopy in the early post-operative stage should be carried out only in exceptional cases, and then only by an experienced surgical endoscopist.