Post-Laparoscopic Surgery Complications: Fever and Abdominal Pain Insights

Post-laparoscopic surgery

Hello, I started experiencing frequent urination and difficulty urinating in January and February of this year.
On March 9, I visited a urologist and was prescribed antibiotics.
Urinalysis results showed red blood cells at 100-150 (not during menstruation) and white blood cells at 25-50.
An X-ray revealed a white spot in the ureter, and on March 26, a double J stent was placed.
During the surgery, it was discovered that the white spot was actually located outside the ureter.
After the surgery, I began to monitor my temperature, which consistently ranged from 37.8 to 38.3 degrees Celsius, with a maximum of 38.5.
Therefore, on April 15, the doctor removed the drainage tube early, but the fever symptoms persisted.
I then consulted an adult infectious disease specialist for a series of tests, but no significant issues were found.
I subsequently saw a gynecologist, and a CT scan revealed a 6 cm teratoma on the right ovary (the white spot previously identified by the urologist was a bony teratoma).
I underwent laparoscopic surgery to remove it on May 3 and was discharged on May 6.
However, five days post-surgery, I am still experiencing severe abdominal bloating, despite taking anti-bloating medication and walking more.
I also have intermittent severe stabbing pain accompanied by cramping (much more painful than the V-GENTA injection).
Today, after experiencing pain, I measured my ear temperature, which rose to 38.7 degrees Celsius.
Could you please provide your diagnostic opinion regarding my ongoing fever since March and the sudden abdominal pain post-surgery? I have been to multiple consultations over the past two months and am feeling overwhelmed.
I hope to receive a more comprehensive response.
Thank you!

Tiffany, 20~29 year old female. Ask Date: 2019/05/09

Dr. Huang Jianzhong reply Obstetrics and Gynecology

In January and February of this year, I began experiencing frequent urination and difficulty urinating.
On March 9, I visited a urologist and was prescribed antibiotics.
Urinalysis results showed 100-150 red blood cells (not during menstruation) and 25-50 white blood cells.
An X-ray on March 26 revealed a white spot in the ureter, and a double J stent was placed.
During the surgery, it was discovered that the white spot was actually located outside the ureter.
After the surgery, I started to monitor my temperature, which consistently ranged from 37.8 to 38.3 degrees Celsius, peaking at 38.5 degrees.
Consequently, on April 15, the doctor removed the drainage tube early, but the fever symptoms persisted.
I then consulted an adult infectious disease specialist for a series of tests, but no significant issues were found.
I subsequently saw a gynecologist, and a CT scan revealed a 6 cm teratoma on the right ovary (the white spot previously seen by the urologist was identified as a bony structure of the teratoma).
I underwent laparoscopic surgery on May 3 and was discharged on May 6.
Five days post-surgery, I still experience severe abdominal bloating despite taking anti-bloating medication and walking more.
However, I occasionally have intense stabbing pain accompanied by cramping in my abdomen (which is much more painful than receiving a V-GENTA injection).
Today, after experiencing pain, I measured my ear temperature, which rose to 38.7 degrees Celsius.
I would like to ask the doctor for a diagnostic opinion regarding my ongoing fever since March and the sudden abdominal pain post-surgery.
I have been to multiple consultations over the past two months and am feeling overwhelmed.
I hope to receive a more comprehensive response.

Answer: For a complete response, it is necessary to visit a hospital (medical center) for examination and detailed discussion with a physician.

Reply Date: 2019/05/09

More Info

Post-laparoscopic surgery complications can be quite concerning, especially when symptoms such as fever and abdominal pain persist. Based on your detailed description, it appears that you have experienced a complex series of medical issues following your surgeries, which can understandably lead to frustration and anxiety.

Firstly, it’s important to recognize that post-operative fever is not uncommon. After any surgical procedure, the body undergoes a healing process that can sometimes trigger a mild fever as part of the inflammatory response. However, persistent fever, especially when accompanied by significant abdominal pain, warrants further investigation. In your case, the fever ranging from 37.8 to 38.5 degrees Celsius, along with the abdominal pain, suggests that there may be an underlying issue that needs to be addressed.

Your history of urinary issues, including frequent urination and difficulty urinating, followed by the discovery of a mass in the ureter, indicates that there may have been complications related to the urinary tract. The subsequent surgeries, including the placement of a double J stent and the removal of a teratoma from the ovary, add layers of complexity to your recovery. The fact that you experienced a fever after these procedures suggests that there could be an infection or inflammation that has not yet been resolved.

The abdominal pain you describe, particularly the severe cramping and the sensation of bloating, could be attributed to several factors. Post-operative pain is common, and it can be exacerbated by the presence of gas in the abdominal cavity, which is often a result of laparoscopic surgery. This gas can irritate the diaphragm and cause referred pain in the shoulder or chest area. Additionally, if there was any manipulation of the intestines during surgery, it could lead to temporary ileus (a slowdown of bowel activity), which might explain the bloating and discomfort.

Moreover, the risk of complications such as infection, abscess formation, or even bowel obstruction should be considered, especially given the history of abdominal surgery. The fact that your pain has escalated to a level that disrupts your sleep is concerning and should be evaluated by your healthcare provider.

In terms of next steps, it is crucial to follow up with your healthcare team. Given the persistence of your symptoms, a thorough evaluation is warranted. This may include imaging studies such as an ultrasound or CT scan to assess for any complications like abscesses or obstructions. Blood tests may also be necessary to check for signs of infection or inflammation.

Regarding your question about whether you should return to your physician, the answer is a resounding yes. If your symptoms are worsening or not improving, it is essential to seek medical attention. Your healthcare provider can assess your condition more thoroughly and determine if further intervention is necessary.

Lastly, while the concern for hernias post-surgery is valid, it is essential to differentiate between normal post-operative pain and pain indicative of a hernia. Hernias typically present as a bulge or protrusion at the surgical site, which may or may not be painful. If you notice any such changes, it is important to inform your doctor.

In conclusion, your symptoms of persistent fever and abdominal pain following laparoscopic surgery are significant and should not be overlooked. It is essential to communicate openly with your healthcare provider about your symptoms and concerns, as they can provide the necessary evaluations and interventions to help you on your path to recovery.

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