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Has Colon Cancer, Undergone Right Hemicolectomy. Suffer From Persistent Hiccups. Have Black Fluid Accumulation In Stomach. What To Do?

Posted on Tue, 25 Jun 2013

Question: Hi, I have a question regarding m father. He has colon cancer with peritoneal carcinomatosis. He has undergo right hemicolectomy and recovered well in one week. But soon after problems startes, firts heartburn, and then persistent hiccups. Now those are resolved but we have bigger problems. His stomach is constantly accumulating black (coffe ground) fluid. He is currenly in hospital, most of the time with NG tube draining black fluid from stomach. After couple of days of NG tube and medications treatment they pulled out NG tube and after 24 hours black vomitting happens again. This is now 3rd week in hospital and we still don't know what is causing so much black fluid accumulation and why it can't be treated?

Answered by Dr. dr. Jawahar Ticku (1 hour later)

Dear,

Normally this should not happen what you are explaining. I think we need to give it some time more to see the quantity of coffee ground fluid gets reduced day by day.

Your father needs to be on conservative management at the hands of the doctor who performed the surgery and if it does not Wane in process of time some manipulation needs to be done as per the advice of your surgeon or the gastroenterologist. It can definitely be treated.

Truly,
Dr. J. Ticku

Above answer was peer-reviewed by : Dr. Shanthi.E

Follow up: Dr. dr. Jawahar Ticku (45 minutes later)

Thank you very much for your answer. But now it has passed almost two months since surgery and black fluid is accumulating more often last days. So basicaly one day he throw up 2+ liters of black liquid, then they drain everything with NG tube for two days, and after pulling NG tube out it happens again. When the NG tube is inside him after cca 24 hours there's only yellow fluid in bag and afterwords they are pulling NG out. So this is happening for last 3 weeks. They sadi that they found some kind of erosions on stomach and esophagus, but by my knowledge those can be treated.
Also, when searching online for peritoneal carcinomatosis I didn't find any case of constant black fluid vomitting. Now, I know that this is really advanced cancer, but I think that black fluid is not caused by cancer, rather by something else. Could it be gastric varicies, slow bowel movements or something else?

Thank you.

Answered by Dr. dr. Jawahar Ticku (25 minutes later)

Dear,
Thank you for your further query. There is some leakage due to formation of an interior fistula. If you keep them draining it gets closed by self healing process. If it doesn’t happen I am afraid again a surgical manipulation may be needed unless it is not eroded by tumor.. This is a surgical complication to be treated by surgery only if it does not heal conservatively. Peritoneal carcinomatosis as such is not the cause. Your surgeon knows it better why this is happening. He must be giving it a chance to heal by itself.
truly,
dr. J. Ticku

Above answer was peer-reviewed by : Dr. Shanthi.E

Follow up: Dr. dr. Jawahar Ticku (7 hours later)

Thank you for your answer. Just one more question. Can a person live with NG tube inside him all the time? Because only when the tube is inserted everything seems fine.

Thank you.

Answered by Dr. dr. Jawahar Ticku (6 hours later)

Dear XXXXXX,

There is no problem if the NG tube is constantly there; but psychologically and aesthetically it will not not be acceptable.
Maintaining hygiene will prevent from any untoward effect. More so feeding him properly under the advice of dietician will not cause the deficiency state caused due to the contents draining out through the NGtube.

I have the feeling that in the long run the tube should be out.

Truly,
Dr. J. Ticku

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Above answer was peer-reviewed by : Dr. Prasad