Post-appendectomy issues?
Hello doctor, I underwent traditional surgery for acute appendicitis in mid-December.
The doctor mentioned that there was localized peritonitis and some adhesions, which caused the surgery to take longer to remove the appendix.
After the surgery, I had a drainage tube and was hospitalized for a week.
Two months after discharge, I experienced discomfort at the surgical site and returned for an examination, where inflammation was discovered.
The attending physician said it was the first time he encountered inflammation two months post-surgery.
He used a needle to aspirate pus, and after incising and debriding the swollen area, allowed the pus to drain out and prescribed antibiotics.
I improved after a week, but a week later, the wound started to hurt again.
I returned for a follow-up, but no pus was aspirated.
The doctor continued antibiotic treatment.
Five days after starting the antibiotics, a small hole suddenly appeared in the wound, and a pinkish pus began to drain out on its own.
The attending physician said I would be fine after finishing the antibiotics, but I still experience pain and a hard lump when pressing on the wound.
I also feel discomfort after meals and have some nausea and a sense of reflux.
Is this normal, or do I need to undergo further examinations? Thank you.
Yu Xia, 30~39 year old female. Ask Date: 2022/03/14
Dr. Chen Jiaming reply Surgery
It is indeed rare for a wound infection to occur two months after an appendectomy.
The subsequent drainage of residual pus, along with antibiotic treatment, is a reasonable course of action.
Due to recurrent inflammation, the scar tissue effect (including hardness and tenderness) may be more pronounced.
Timely follow-up appointments to discuss and communicate your clinical condition with your physician should help address your concerns.
Take care!
Reply Date: 2022/03/14
More Info
After an appendectomy, it is not uncommon to experience complications such as pain and infection. Your situation, where you had an acute appendicitis that required a traditional surgical approach, followed by a prolonged recovery with signs of infection, is a scenario that warrants careful consideration.
Firstly, the presence of localized pain and discomfort after surgery can be attributed to several factors. Surgical procedures, especially those involving the abdomen, can lead to inflammation, scarring, and adhesions. Adhesions are bands of scar tissue that can form between abdominal tissues and organs, which may cause pain and discomfort as they can restrict movement and lead to complications.
In your case, the initial post-operative period was complicated by the development of localized peritonitis and adhesions, which extended your surgery time. The insertion of a drainage tube indicates that there was a concern about fluid accumulation or infection, which is a common precaution in surgeries involving the abdomen.
The subsequent development of an abscess, as indicated by the need for aspiration and incision, suggests that there was an infection that needed to be addressed. The fact that you experienced a recurrence of pain and discomfort after the initial treatment, along with the formation of a small opening at the wound site, indicates that the infection may not have been fully resolved. This can happen if the abscess was not completely drained or if there are residual pockets of infection.
The symptoms you describe, such as ongoing pain, the presence of a hard lump, and gastrointestinal discomfort (nausea and a feeling of fullness after eating), are concerning. While some discomfort can be expected after surgery, persistent or worsening symptoms should not be overlooked. The fact that you are experiencing these symptoms several weeks after the initial treatment suggests that further evaluation is warranted.
In terms of next steps, it is crucial to follow up with your healthcare provider. They may recommend additional imaging studies, such as an ultrasound or CT scan, to assess for any remaining abscesses or complications. It is also important to discuss the ongoing pain and gastrointestinal symptoms, as these could indicate a need for further intervention or a change in your treatment plan.
In summary, while some post-operative pain and discomfort can be normal, the persistence of your symptoms, especially with the history of infection, suggests that further evaluation is necessary. It is essential to communicate openly with your healthcare provider about your concerns and symptoms to ensure that you receive the appropriate care and management for your recovery.
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