Perioperative care of the orthopedic patient with gastrointestinal and liver issues

Abstract

Several gastrointestinal problems occur with relative frequency in the perioperative orthopedic setting. Abnormal preoperative liver function studies are often benign although various conditions, specifically cirrhosis, are important to define before surgery is performed; other gastrointestinal complications arise postoperatively. These include nausea, vomiting, and more severe conditions such as abdominal ileus and C. difficile colitis. Physicians involved in postoperative care need to be familiar with these conditions, the presentation of which may be subtle but may evolve producing severe morbidity. This chapter reviews the most common of the postoperative gastrointestinal problems, and the best strategy for avoiding and dealing with these perioperative complications is anticipation, prevention, and early therapy.