Post-Appendectomy Complications: Pain from Abdominal Abscess

Post-appendectomy intestinal abscess?

Hello, I underwent an appendectomy at the beginning of August and experienced complications, including a large abscess approximately 4 cm in size in the intestinal area.
After 10 days of antibiotic treatment, I was discharged on August 27.
However, I have recently been feeling a throbbing pain at the site of the abscess, which has been affecting my sleep, and the pain seems to be worsening.
Is it normal to experience throbbing pain after surgery? Thank you for your response.

WW Wong, 20~29 year old female. Ask Date: 2018/09/03

Dr. Chen Jiaming reply Surgery

Postoperative complications of acute appendicitis can include intra-abdominal abscesses.
If the abscess is located in the interloop space, it may be difficult to achieve effective treatment through drainage alone.
Simply administering antibiotics may sometimes fail to provide a complete cure (or may prolong the treatment duration) and can lead to recurrence (with some strains developing antibiotic resistance).
Therefore, considering your condition just one week post-discharge, it is advisable to return for a follow-up consultation and undergo relevant examinations if there are any clinical changes of concern, to confirm the possibility of recurrence.

Reply Date: 2018/09/03

More Info

Post-appendectomy complications can be concerning, especially when it involves the development of an abdominal abscess. After an appendectomy, it is not uncommon for patients to experience some degree of pain as part of the healing process. However, the presence of a significant abscess, such as the 4 cm one you mentioned, can lead to more complex symptoms and complications.

1. Understanding Pain After Appendectomy: Pain following an appendectomy can arise from several sources, including surgical trauma, inflammation, and the body's healing response. Generally, mild to moderate pain is expected in the days and weeks following the surgery. However, if the pain is severe, persistent, or worsening, it may indicate complications such as an abscess, infection, or other issues related to the surgical site.

2. Abscess Formation: An abdominal abscess is a localized collection of pus that can occur after surgery due to infection. Symptoms of an abscess may include localized pain, fever, and sometimes changes in bowel habits. The pain you are experiencing, particularly if it is described as "throbbing" or "sharp," could be a sign that the abscess is not resolving as expected. The fact that the pain is worsening is particularly concerning and warrants further evaluation.

3. Management of Abscess Pain: If you are experiencing increasing pain at the site of the abscess, it is crucial to consult your healthcare provider. They may recommend imaging studies, such as an ultrasound or CT scan, to assess the size and nature of the abscess. Depending on the findings, treatment options may include continued antibiotic therapy, drainage of the abscess, or further surgical intervention if necessary.

4. When to Seek Medical Attention: You should seek immediate medical attention if you experience any of the following symptoms:
- Fever or chills
- Increased swelling or redness around the surgical site
- Severe abdominal pain that does not improve with over-the-counter pain medications
- Nausea or vomiting
- Changes in bowel movements or urinary symptoms
5. Postoperative Care: After surgery, it is essential to follow your surgeon's postoperative care instructions, including activity restrictions and signs of complications to watch for. If you have been prescribed antibiotics, ensure you complete the full course, even if you start to feel better.

6. Pain Management: While pain management is important, relying solely on pain medications without addressing the underlying cause can lead to complications. If you find that over-the-counter pain relief is insufficient, discuss this with your healthcare provider, who may adjust your pain management plan.

In summary, while some pain after an appendectomy is normal, the increasing pain you describe, especially in the context of a known abscess, is concerning. It is essential to communicate these symptoms to your healthcare provider promptly to ensure appropriate management and prevent further complications. Your health and recovery are paramount, and timely intervention can make a significant difference in your outcome.

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