Surgery

During their illness, patients with gut PD may encounter the need for urgent or elective surgery. Several scenarios may be envisioned: Surgery may be extraintestinal, frequently orthopedic, or performed for other indications, such as coronary heart disease or cancer. In such cases, the surgeon needs to consider any possible risks that the underlying gut PD poses in the perioperative period, such as pulmonary aspiration or embolization. Gut PD may or may not be symptomatically apparent or known at the time of surgical decision-making. An example is underlying gastroparesis, common in gut PD and predisposing to aspiration, or small bowel and colonic dysmotility, potentially leading to prolonged postoperative ileus or Ogilvie’s syndrome.