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What Causes Umbilical Hernia Strangulation After A Flying?
Question: My dad traveled to Guyana and got sick on the flight. He was then told at the hospital in Guyana that his Umbilical Hernia was in strangulation but he would have to wait 2 days for a surgeon to take care of it.
They did a minor operation where they claimed to have temporary relieved him but they mentioned that he would need another operation. While doing the operation they noticed that his intestines were damaged but said they are waiting for it to be repaired. 3 days after the surgery he is unable to eat. He has not eaten for 5 days and keeps throwing up although he is only being given water and coconut water.
Guyana has horrible medical and lack of doctors. We are working to get my father back into the US but can you help me out by telling me how normal it is to vomit days after sugery? He also complains of pain and can't move much. he is coughing a lot.
They did a minor operation where they claimed to have temporary relieved him but they mentioned that he would need another operation. While doing the operation they noticed that his intestines were damaged but said they are waiting for it to be repaired. 3 days after the surgery he is unable to eat. He has not eaten for 5 days and keeps throwing up although he is only being given water and coconut water.
Guyana has horrible medical and lack of doctors. We are working to get my father back into the US but can you help me out by telling me how normal it is to vomit days after sugery? He also complains of pain and can't move much. he is coughing a lot.
Brief Answer:
There should not be any vomiting at all.
Detailed Answer:
Hi.
Thanks for your query and faith in us.
Read the history and understood the problem your Father has.
It is not at all normal to vomit after surgery on any single day.
Pain, inability to move and coughing is a sign of possible complications.
What I can gather from your description is the word '' strangulation '' . This means that a part of the intestines which was trapped in the hernial sac got devitalized, that is damaged. You / we have to make it certain that the damaged intestine has to be removed and an end-to-end anastomosis (attaching together the healthy parts to maintain the continuity) is carried out. Cleaning of the abdominal (peritoneal) cavity with lots of normal saline is done and the patient is usually kept nil orally till we are sure that the intestinal anastomosis is healed well.
Minor operation can not be carried out in strangulated hernia.
By temporarily relieving the obstruction only, the doubtful part of the intestine might have back into abdominal cavity causing all the problems your Father has OR if they have removed the damaged part, the anastomosis might not healed or given away.
It is really difficult to say what exactly would have been done by the Doctor at Guyana.
Is it possible for you to get more information ?
From the history you have provided , I would advise you the following.
Talk to the Doctors taking care of your Father.
Request the Surgeon to take over if you can not sift back to US and request him to carry on the investigations, have a second-look surgery and to rectify any defect. This becomes urgent to avoid further complications.
You can ask your Father to stop taking anything orally, be kept on the best available antibiotics and intravenous fluids.
I hope this answeer helps you, please feel free to ask for any clarifications you need to, I shall be really happy to assist you and Your Father.
There should not be any vomiting at all.
Detailed Answer:
Hi.
Thanks for your query and faith in us.
Read the history and understood the problem your Father has.
It is not at all normal to vomit after surgery on any single day.
Pain, inability to move and coughing is a sign of possible complications.
What I can gather from your description is the word '' strangulation '' . This means that a part of the intestines which was trapped in the hernial sac got devitalized, that is damaged. You / we have to make it certain that the damaged intestine has to be removed and an end-to-end anastomosis (attaching together the healthy parts to maintain the continuity) is carried out. Cleaning of the abdominal (peritoneal) cavity with lots of normal saline is done and the patient is usually kept nil orally till we are sure that the intestinal anastomosis is healed well.
Minor operation can not be carried out in strangulated hernia.
By temporarily relieving the obstruction only, the doubtful part of the intestine might have back into abdominal cavity causing all the problems your Father has OR if they have removed the damaged part, the anastomosis might not healed or given away.
It is really difficult to say what exactly would have been done by the Doctor at Guyana.
Is it possible for you to get more information ?
From the history you have provided , I would advise you the following.
Talk to the Doctors taking care of your Father.
Request the Surgeon to take over if you can not sift back to US and request him to carry on the investigations, have a second-look surgery and to rectify any defect. This becomes urgent to avoid further complications.
You can ask your Father to stop taking anything orally, be kept on the best available antibiotics and intravenous fluids.
I hope this answeer helps you, please feel free to ask for any clarifications you need to, I shall be really happy to assist you and Your Father.
Above answer was peer-reviewed by :
Dr. Vinay Bhardwaj
I am working to get a report on what the doctors did in the Hospital. We feel hopeless in the hands of these doctors because they aren't as good as the ones in the United States. Healthcare is horrible.
They let him in pain for 2 days with a hernia strangulaed and then then did a minor cut to ''temporarily relieve it'' I am now headed to the hospital because the doctors said they are doing one more test.
They let him in pain for 2 days with a hernia strangulaed and then then did a minor cut to ''temporarily relieve it'' I am now headed to the hospital because the doctors said they are doing one more test.
Brief Answer:
Please give feedback
Detailed Answer:
The symptoms are suggestive of a complications.
The signs ( that the Surgeon examines) are very important. For example if there is 'rebound tenderness' meaning if you put a hand on the abdomen, press lightly and then release the pressure suddenly- the there is increase in pain or if the patient winches in pain, this indicates there is peritonitis and is a sufficient indication for exploration / surgery to find out the cause, treat it, have peritoneal toilet (medical word for cleaning the peritoneal . abdominal cavity with warm normal saline).
Which test are they doing ?
Please let me know the result.
You can contact me on phone if you wish to through our office of Ibix in XXXXXXX
Me too waiting for your feedback.
Please give feedback
Detailed Answer:
The symptoms are suggestive of a complications.
The signs ( that the Surgeon examines) are very important. For example if there is 'rebound tenderness' meaning if you put a hand on the abdomen, press lightly and then release the pressure suddenly- the there is increase in pain or if the patient winches in pain, this indicates there is peritonitis and is a sufficient indication for exploration / surgery to find out the cause, treat it, have peritoneal toilet (medical word for cleaning the peritoneal . abdominal cavity with warm normal saline).
Which test are they doing ?
Please let me know the result.
You can contact me on phone if you wish to through our office of Ibix in XXXXXXX
Me too waiting for your feedback.
Above answer was peer-reviewed by :
Dr. Vinay Bhardwaj
The hospital said they were not sure what caused the stomoch ache and said they would take him back into surgery. he stopped vomiting so they didn't bother to do it and then sent him home.
He was okay for a day but now that he has become to eat he is becoming sick again. He has no bowel movements and feels upset or dizzy. We have CT and some other scans that they did.
The surgeon mentioned that the scan shows the Hernia is still there but that would be impossible because he repaired it. Something seems wrong here. I am not sure how I would be able to show you those scans because you usually need on a white lit board.
He was okay for a day but now that he has become to eat he is becoming sick again. He has no bowel movements and feels upset or dizzy. We have CT and some other scans that they did.
The surgeon mentioned that the scan shows the Hernia is still there but that would be impossible because he repaired it. Something seems wrong here. I am not sure how I would be able to show you those scans because you usually need on a white lit board.
Brief Answer:
Scan the reports and attach to this query, we have
Detailed Answer:
Thanks for your feedback.
It appears that your Father improved on conservative management after the first surgery , so they sent home. And now once he started eating, the problem of feeling sick, upset, dizzy and no bowel movements have reappeared.
You can scan or take a photograph against white background and attach to this query. Please post the scanned reports also. Or you can send to YYYY@YYYY and with subject as ATTN: Dr.Chandrakant
A would like to know few things related to your Father:
Is there any fever / distension of abdomen, inability to pass stool / gases, / vomiting / Pain in abdomen on movement ?
Umbilical hernia has a complication to develop Richter's type strangulation wherein only a part of the bowel gets strangulated. On anesthesia the ring becomes loose and the intestine with partial strangulation goes back to the abdomen where it will be difficult to find without a formal Laparoscopy / Laparotomy.
If the symptoms reappear or there are sign of peritonitis, another surgery may be needed.
Please post the scanned copies of all the reports of CT scan and other reports like ultrasonography, blood and so on. Also post the discharge Ticket they must have provided , which gives operative procedure performed.
A simple test of rebound tenderness can help us in deciding about peritonitis. In this you can put a minimal pressure on the abdomen and then suddenly lift up the hand, if there is pain on immediately removing the hand, this is called rebound tenderness and is indicating peritonitis. Please try and let me know.
Scan the reports and attach to this query, we have
Detailed Answer:
Thanks for your feedback.
It appears that your Father improved on conservative management after the first surgery , so they sent home. And now once he started eating, the problem of feeling sick, upset, dizzy and no bowel movements have reappeared.
You can scan or take a photograph against white background and attach to this query. Please post the scanned reports also. Or you can send to YYYY@YYYY and with subject as ATTN: Dr.Chandrakant
A would like to know few things related to your Father:
Is there any fever / distension of abdomen, inability to pass stool / gases, / vomiting / Pain in abdomen on movement ?
Umbilical hernia has a complication to develop Richter's type strangulation wherein only a part of the bowel gets strangulated. On anesthesia the ring becomes loose and the intestine with partial strangulation goes back to the abdomen where it will be difficult to find without a formal Laparoscopy / Laparotomy.
If the symptoms reappear or there are sign of peritonitis, another surgery may be needed.
Please post the scanned copies of all the reports of CT scan and other reports like ultrasonography, blood and so on. Also post the discharge Ticket they must have provided , which gives operative procedure performed.
A simple test of rebound tenderness can help us in deciding about peritonitis. In this you can put a minimal pressure on the abdomen and then suddenly lift up the hand, if there is pain on immediately removing the hand, this is called rebound tenderness and is indicating peritonitis. Please try and let me know.
Note: For further inquiries on surgery procedure and its risks or complications book an appointment now
Above answer was peer-reviewed by :
Dr. Bhagyalaxmi Nalaparaju
Answered by
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