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Forum Name: Gastroenterology Topics

Question: post inguinal hernia diaherra upper abd pain followed by con


 jaybirdalleymale - Mon Sep 15, 2008 2:12 am

6/12/08 Dbl inguinal laprosopic hernia repair (mesh used).Watery stools since,firmness & pain on left side.8/21/08 surgeon prescribed antiinflammatory & lortab for 30 days.9/5 back to general physician as pain increased, he said mesh seemed manipulative, stomach distended and rigid,did xrays &blood, white count 8.5, diagnosed peritonitis.Steroid & anceph injection, prescribed cipro,dexpak and lortab & sched CT w & w/o contrast for 9/8 (no more bowel movements after 9/5). 9/8 said ct showed contrast reaching rectum, 6 lbs gained, white count 16.?. Ref back to surgeon expecting hosp admiss for iv antibiotics. Surgeon's associate stopped those meds and presc flagyl (4) and stool sample for c-diff (we have no insurance).9/9 saw original surgeon, diagnosed colitis (although still had not been able to collect stool sample)prescr more flagyl 1-3x day,more lortab, glycerin suppositories and OTC laxatives.9/10 aft several suppositories & laxatives got very small stool sample - c-diff negative. ordered 2 more stool samples. 9/11am got another minimal stool sample after 5 laxatives & 3 glyc supp, however later in day pain reached chest area, however heart checked out ok by EMS.Surgeon adv to got ER.Upon arrival iv saline,nausea med, followed by dilaudid and xrays and without further consult admitted to hosp. More labs drawn, urine output okay, saline iv cont. Internists, gastro & orig surgeon assigned. Ultrasound ordered on upper abdomen. GoLytely prescribed (only @ 3 cups down)before hard vomiting w/tinge of blood started. Ultrasound ordered.(all this while temp avg 95.5. Told us white count back to 8 (normal? they said)Orders for dilaudid every 4 hrs for pain.Vomited few more times - still no b.m.'s. Gave zofran. Tried more Golytely, more vomiting. Confirmed c-diff neg. 9/12 sm sample amt of stool provided (some consistency).Any liquid intake resulted in vomiting. Thinking of ordering MRI(in motion?)Internist said - air all way thru to rectum, lack of air in small bowel, getting to colon, small intestin too packed to find any kinks, hernia seperate issue. Surgeon said-(5x)not surgical (almost certain), he cannot figure out, internist cannot figure out, gastroint cannot figure out, ultrasound appears normal, bile duct is a little big, white count is normal - this is justa a zebra that we may never figure out. It is nothing major, everything has benn ruled out and requested NG tube and enemas. Gastroentologist said he saw nothing wrong and that no contrast (4 days later) was visible so it had to go somewhere. Nurse admin Reglan and NG tube inserted.Tube removed after 2 hrs (nothing but sm amt of mucus), but then had a semi normal bowel movement. More labs ordered.@ 6 hrs after 1st dose more reglan given and then again 6 hrs after that. Had two more bowel movements. Distention seemed to go way down. (during all of this no belching (usually norm for him) and was passing some gas).Sugeon wanted him to try more GoLytely but according to warnings on the label, without ruling out alot og gastro problems or perforations it should not be admin, so we refused. All these doctors going to be gone for 2-3 days and since looking up all the meds they had been giving him all had warnings about using without ruling out several gastro problems we discharged from the hospital.9/14 began watery bowel movements again. Afraid surgeon changed orders by internist several times, we no longer feel comfortable w/him (arrogant and continually reminding us that it is not a surgical issue - so why is he on the case?) what now - gather all results and go somewhere else? Small town, no insurance and everyone comments surgeon is best there is - but we feel since he pretty much ignored the fact that 2 mos aft surgery bowel movements had not returned to normal, something odd is up. Mesh used - don't' know if that could be problem (heard of several recalls). Help us please, being uninsured we cannot affored to do one test a day as experiments, at their leisure. thank you for any advise and who we should follow up with. A gastro, a surgeon, an internist, the hospital? (Our g.p. has not hospital privileges here). Do we go to another town to seek this help and from whom/type?
 Dr.M.Aroon kamath - Tue Oct 20, 2009 8:54 pm

User avatar Hi,
It is possible that you developed an ileus (rather prolonged one, at that).
In some individuals, certain drugs such as morphine may lead to this kind of an effect.
Ileus may also result as a result of the surgery itself (as with any abdominal surgery) and its duration is unpredictable (varies on a case to case basis).
I hope you have improved by now.We will be glad to hear from you.

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