The picture that led to () to submit to this Sunday (13) to since 2018 is more serious than the other times and its prognosis is uncertain, says doctors specialists on the subject.
The procedure began around 10:20 am and, in posting at 6 pm, former first lady Michelle Bolsonaro said she would take another hours to be completed.
The trauma of stabbing in the gut during the 2018 election campaign and successive interventions caused adhesions (parts of the agency that are glued) that lead to the obstruction of intestinal transit.
According to surgeons heard by Sheetthe surgery this time is at higher risk because the place is weakened by the number of.
According to them, every time someone suffers a severe trauma, such as a stab, and is operated, that is, that the abdominal cavity is violated in some way, adhesions, something intrinsic to the organism and the healing process.
“Healing generates fibrosis and adhesions. The more often you enter the abdominal cavity, the peritoneum, and move in the intestines, the more and more adhesions come,” explains Diego Adam, Professor of Surgical Emergency at Unifesp (Federal University of São Paulo).
He states that these adhesions have a phase, usually in the first six months after surgery, where they are harder and more. Over time, the body itself undoes some of them.
However, in the case of those who have had many surgeries, such as Bolsonaro, no matter how long it is expected, some adhesions never get rid of.
“So it’s true that it’s today’s surgery will be harder than the previous one, which was more difficult wants the previous one and so on. The tendency is getting harder and harder.”
According to Carlos Walter Sobrado, professor free professor at the USP Faculty of Medicine Gastroenterology Department, these adhesions make various structures within the abdominal wall stuck with each other.
“It’s like a superbonder glue. Sometimes it sticks the gut with vital structures, bowel -like pancreas, liver, gallbladder, aorta artery, ureter and intestinal straps themselves.”
According to him, the intestinal obstruction diagnosed this week in Bolsonaro may have occurred due to one of these scenarios above, which increases the difficulty of surgery.
“In intestinal adhesions, the surgeon never knows what they will find, you only have one idea. We joke that it is surgery for doctors who have white hair, ie surgery for those who have already operated a lot of trauma, urgent cases, personnel specializing in gastrointestinal surgeries.”
It is not yet known which grip caused the current intestinal obstruction. “If it is a superficial and unique grip, it may not be necessary to undo everything that is adhered to and can solve only the point of current obstruction,” says Diego Adam of Unifesp.
Sobrado states that, even in the hands of good and experienced surgeons, there are risks during the detachment of Bolsonaro’s adhesions. “You can pierce a new strap that is stuck very strong. As much as it goes slowly, with great patience, it can pierce an organ.”
The former president is also not free to return to the same problem in the future. He can be fine and, in a while, have new crises for new adhesions and need new surgeries, they said.
According to Unifesp professor, the most serious scenario now would be the medical team not to find a specific point of obstruction. In such cases, one option is to try to release all visible adhesions. If this happens, Bolsonaro may be more hospitalized, a need for parenteral diet (by the vein).
There is also the hypothesis that the surgical team cannot solve any adhesion and have to close without solving the problem. This is what is called frozen abdomen, when almost nothing is possible to be done.
“You need to see what will happen inside the surgery to find out which scenario going forward. It may not be the worst and that, after the surgery, he can return to the early stage.”
Adam says the procedure does not move vascular or high -risk structures. According to townhouse, the literature points out that the mortality rate in these cases of intestinal adhesions is between 2% and 6%. “But as they are very experienced people who are taking care of Bolsonaro, it must go well.”
Collaborated Flávio Ferreira
