Doctors Lounge - Gastroenterology Answers
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Forum Name: Gastroenterology Topics
Question: Continued pain following colon resection
|Edelein - Sun Apr 05, 2009 12:37 am||
My mother is 80 years old and one month post-op following laporascopic colon resection for chronic diverticulitis. Her recovery has been essentially unremarkable except for the fact that she keeps having right-sided pain which she describes as fairly consistent in intensity. She has not taken any pain medicine since her release from the hospital, as her pain is not unbearable. Her bowel movements have been numerous (sometimes more than a half dozen times a day) though they are fairly well formed and no noticeable bleeding. Her heart rate and temperature have been normal throughout.
On her post-op visit to the surgeon (which she had 10 days following discharge from the hospital), he did not seem too concerned with her complaints. He did put her on a 5 day course of Diflucan since she had developed oral thrush. He also sent her for a C-diff test which came back negative. He told her to come back in another 2 weeks, sooner if she became worse.
She returns for her 2 week visit this coming week. She continues to have the right sided pain (though it hasn't increased in intensity). Her stools were "normal" for about 1 week in both number and consistency. However, the number of daily movements is again increasing, though the consistency remains fairly "normal."
What should we be asking the surgeon on her return visit? Could the pain be related to leakage? If so, would she not have abdominal tenderness and/or fever? She cannot have an MRI (due to implanted metal in the brain), but would a CT, ultrasound, and/or colonoscopy be warranted? Any enlightenment you can shed would be greatly appreciated. Thank you.
|John Kenyon, CNA - Wed Apr 15, 2009 12:01 am||
The intermittent frequent bowel movements are likely to short gut syndrome, which often occurs after colon resection, This probably has nothing to do with the pain, and with leakage, yes, there would almost certainly be fever and local tenderness at the least, septic shock at the worst. The pain would seem to be due to some tangential problem, possibly adhesions which can form after even laparascopic surgery. Since the scheduled exam is close and there is no fever nor any severe pain it's probably fine to wait, but this issue should at least be investigated during that visit, and an ultrasound study of the affected area would probably be the best starting point.
I hope this helps. Good luck to you and your mother and please follow up with us as needed and also update us after the followup visit.
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