Post-Surgery Concerns for Umbilical Urachal Remnant Closure

Postoperative issues following patent urachus closure surgery?

Hello Doctor, I was diagnosed with a patent urachus about a month ago and underwent surgical excision.
Since I have type 1 diabetes, the doctor advised me to be cautious about the possibility of recurrent infections.
Recently, my wound has almost healed, but my abdomen feels consistently bloated with a sinking sensation, and I am experiencing pain in the left lower abdomen similar to what I felt before the surgery, which seems to be worsening day by day.
However, there is no discharge or odor from the umbilicus, and my bowel movements are normal.
There is also no significant pain upon palpation.
What should I be aware of? Is there a possibility that an infection has recurred?

Niming, 20~29 year old female. Ask Date: 2020/12/31

Dr. Chen Jiaming reply Surgery

Postoperative conditions can vary depending on the type of surgery performed.
Based on your description, it does not appear to be a specific complication issue, as the original condition was an infection, and antibiotic treatment was likely administered during the treatment process.
Many patients experience abdominal bloating and discomfort after a period of antibiotic therapy due to changes in gut microbiota.
If this is the cause, it is advisable to consider using probiotics or commercially available yogurt (containing various probiotics) to help restore gut flora and alleviate bloating and discomfort.
If the issue is simply due to tension in the sutured tissue or structural problems from the surgical procedure, it would be best to consult the original surgeon for further guidance.
I hope this information is helpful to you.

Reply Date: 2020/12/31

More Info

Post-surgery concerns, especially after a procedure like umbilical urachal remnant closure, can be quite distressing, particularly for patients with underlying conditions such as type 1 diabetes. Your symptoms of abdominal bloating, a sinking sensation, and increasing pain in the left lower abdomen warrant careful consideration.

Firstly, it’s important to understand that after any surgical procedure, especially one involving the abdominal area, patients may experience various sensations as part of the healing process. This can include swelling, discomfort, and even referred pain as the body adjusts and heals. However, the specific symptoms you describe—persistent bloating, a sinking sensation, and increasing pain—could indicate several possibilities.

1. Infection: While you mentioned that there is no discharge or odor from the umbilical area, infections can sometimes present with more subtle symptoms. Given your diabetes, which can impair healing and increase the risk of infections, it’s crucial to monitor for any changes. If you notice fever, chills, or any changes in the appearance of the incision site, you should seek medical attention promptly.

2. Hernia: The sensation of a sinking feeling and localized pain could suggest the possibility of a hernia, particularly if the surgical site has not healed completely. Hernias can occur when internal tissue protrudes through a weak spot in the abdominal muscles, and they can sometimes develop after surgery. If you feel a bulge or if the pain worsens with certain movements or activities, this should be evaluated by your healthcare provider.

3. Adhesions: Post-surgical adhesions can form as part of the healing process. These are bands of scar tissue that can develop between abdominal tissues and organs, potentially causing pain and discomfort. While they are a common occurrence after abdominal surgeries, they can sometimes lead to complications such as bowel obstruction.

4. Gastrointestinal Issues: Sometimes, abdominal pain can be related to gastrointestinal issues rather than the surgical site itself. Conditions such as irritable bowel syndrome (IBS) or other functional gastrointestinal disorders can cause similar symptoms.
5. Diabetes Management: Since you have type 1 diabetes, it’s essential to ensure that your blood sugar levels are well-controlled during the recovery process. Poorly managed diabetes can lead to delayed healing and increased risk of complications.

Given these considerations, it’s crucial to follow up with your surgeon or healthcare provider regarding your symptoms. They may recommend imaging studies, such as an ultrasound or CT scan, to evaluate the abdominal area further and rule out complications. Additionally, they can assess your surgical site and overall recovery progress.

In the meantime, keep track of your symptoms, including any changes in pain intensity, the presence of new symptoms, or changes in your general health. If the pain becomes severe or if you develop any new symptoms, do not hesitate to seek immediate medical attention.

In summary, while some discomfort and sensations are normal after surgery, your increasing pain and abdominal bloating should be evaluated by a healthcare professional to rule out any serious complications. Your health and recovery are paramount, and proactive communication with your medical team is essential.

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