Post-IHD Surgery Abdominal Pain: Causes and Concerns Explained

Postoperative abdominal pain after IHD (Ischemic Heart Disease) surgery?

It has been about 5 days post-surgery, and there are issues with pulmonary effusion and diarrhea.
There is pain in both kidney areas, discomfort and dull pain in the lungs and the entire abdominal cavity, and there is generalized edema, with the extremities being more severe.
Pain relief medication is being taken continuously.
I would like to know why the pain persists.

Niming, 50~59 year old female. Ask Date: 2016/10/25

Dr. Cai Jinji reply Gastroenterology and Hepatology

It is recommended to return to the original hospital to consult with the physician or undergo further examinations for clearer information.

Reply Date: 2016/10/25

More Info

Post-operative abdominal pain following Ischemic Heart Disease (IHD) surgery can be multifactorial and may arise from various complications or underlying conditions. Given the symptoms you described—persistent abdominal pain, pleural effusion (fluid accumulation in the lungs), diarrhea, bilateral flank pain, general discomfort in the abdomen, and systemic edema—it's crucial to consider several potential causes.

1. Surgical Complications: After any major surgery, including IHD procedures, complications such as infection, hematoma (a localized collection of blood outside of blood vessels), or abscess formation can occur. These complications can lead to significant pain and discomfort. In your case, the presence of abdominal pain and systemic symptoms like edema may suggest an underlying infection or inflammatory process.

2. Fluid Accumulation: The pleural effusion you mentioned could be contributing to your discomfort. Fluid in the pleural space can cause referred pain to the abdomen and may also lead to respiratory issues, which can exacerbate feelings of discomfort and pain. Additionally, if there is fluid accumulation in the abdominal cavity (ascites), it can lead to abdominal distension and pain.

3. Gastrointestinal Issues: The diarrhea you are experiencing could be related to several factors, including postoperative changes in bowel function, dietary changes, or even medication side effects (such as from pain medications). Gastrointestinal disturbances can lead to abdominal pain and discomfort, especially if there is an underlying issue such as an infection or inflammation.

4. Kidney Pain: The bilateral flank pain you mentioned could indicate renal issues, such as kidney stones or infection. Post-surgical patients are at risk for developing complications that can affect the kidneys, especially if there is fluid overload or dehydration.

5. Edema: The systemic edema, particularly in the extremities, could be a sign of fluid retention, which can occur after surgery due to various factors, including changes in circulation, kidney function, or medication effects. This can lead to discomfort and a feeling of heaviness in the limbs.

6. Pain Management: The ongoing need for pain medication suggests that your pain levels are significant. While pain management is essential, it is also important to address the underlying causes of your pain. Relying solely on pain medication without investigating the root cause may lead to further complications.

Given these considerations, it is crucial to follow up with your healthcare provider. They may recommend diagnostic imaging, such as an ultrasound or CT scan, to evaluate for any complications such as fluid collections, infections, or other abnormalities. Blood tests may also be necessary to assess kidney function, liver function, and signs of infection or inflammation.

In summary, persistent abdominal pain after IHD surgery can arise from various causes, including surgical complications, fluid accumulation, gastrointestinal disturbances, and renal issues. It is essential to seek medical evaluation to identify the underlying cause and receive appropriate treatment. Early intervention can prevent further complications and improve your overall recovery process.

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