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What Does My CT Scan Report Indicate?
Question: Hi Doctor,
This is XXXX, my husband - 38 yrs old suffering from fever since 2 months, we had approached physician and they had given antibiotics - Lovoflox 1 tab and paracetamol for 10 days, even then the fever did not come down.. later they diverted to gastroenteritis... he suggested to take blood samples and urine, USG, CT,.... in CT they came to know there is abscess in spleen... which might be causing fever and chillness... he underwent parcutanious drainage on 5th XXXXXXX 2015 and the pus was collected and sent for culture, even in culture it did not show any bacteria growth... on 10th XXXXXXX 2015 the pipe which was done in the drainage was removed.. he was under mild antibiotics and signoflame for the pain...
Even after this drainage, he was getting mild fever with chills fever was variying from 98.6 to 100.2.. so.. took him to doctor again, the uSG and Tc DC for blood done, so.. now doctor is suggesting to under to laparoscopic splenectomy... today he took vaccine - pneumococcal vaccine and doctor suggested to take Dolo 650mg if fever comes... As on today, he did not get any fever 15 hrs and he has slight pain above stomach and right shoulder...
We are really worried to under go laproscopic splenectomy.. because it might lead to further more complications..
I have attached few reports for reference..!!
Doctor please help us..
Thanks and regards,
This is XXXX, my husband - 38 yrs old suffering from fever since 2 months, we had approached physician and they had given antibiotics - Lovoflox 1 tab and paracetamol for 10 days, even then the fever did not come down.. later they diverted to gastroenteritis... he suggested to take blood samples and urine, USG, CT,.... in CT they came to know there is abscess in spleen... which might be causing fever and chillness... he underwent parcutanious drainage on 5th XXXXXXX 2015 and the pus was collected and sent for culture, even in culture it did not show any bacteria growth... on 10th XXXXXXX 2015 the pipe which was done in the drainage was removed.. he was under mild antibiotics and signoflame for the pain...
Even after this drainage, he was getting mild fever with chills fever was variying from 98.6 to 100.2.. so.. took him to doctor again, the uSG and Tc DC for blood done, so.. now doctor is suggesting to under to laparoscopic splenectomy... today he took vaccine - pneumococcal vaccine and doctor suggested to take Dolo 650mg if fever comes... As on today, he did not get any fever 15 hrs and he has slight pain above stomach and right shoulder...
We are really worried to under go laproscopic splenectomy.. because it might lead to further more complications..
I have attached few reports for reference..!!
Doctor please help us..
Thanks and regards,
Brief Answer:
Discuss the points with your Doctors.
Detailed Answer:
Hi.
Thanks for our query Mrs XXXXXXX
I can understand the plight you and your husband might be going through.
Undergone the history and all the reports you have attached herewith. The recent CT scan shows
3.8 X 3.6 cm splenic ruptured abscess with subcapsular collection.
Percutaneous drainage was done on 5 th XXXXXXX he tube removed on 10 th XXXXXXX and the mild fever and chills continued.
Since your husband is suffering from 2 months definitive diagnosis and treatment is a must.
One of them is splenectomy. This was the ideal treatment in olden days. With the advent of newer stronger antibiotics, better USG and CT scan machines, percutaneous drainage was attempted.
Since the Splenectomy has already been advised, there is nothing much to suggest as the opinion must have been given by the Specialist.
Yet you can discuss the following with your treating Surgeon / Physician before you say yes to the Splenectomy:
-Blood culture and sensitivity.
-Antibiotic treatment with higher antibiotics.
-Drainage under the Laparoscopic guidance and splenectomy only if it fails / bleeding occurs. This way there is still a chance to save the spleen.
_ To discuss about the chance of Tubercular splenic abscess and the get further investigations for this. If positive Anti-tubercular treatment can be started and yet the spleen be saved.
Please discuss these point in detail and let me know their opinion.
May I please know the Specialty of the Doctor who gave you the decision for splenectomy..
Discuss the points with your Doctors.
Detailed Answer:
Hi.
Thanks for our query Mrs XXXXXXX
I can understand the plight you and your husband might be going through.
Undergone the history and all the reports you have attached herewith. The recent CT scan shows
3.8 X 3.6 cm splenic ruptured abscess with subcapsular collection.
Percutaneous drainage was done on 5 th XXXXXXX he tube removed on 10 th XXXXXXX and the mild fever and chills continued.
Since your husband is suffering from 2 months definitive diagnosis and treatment is a must.
One of them is splenectomy. This was the ideal treatment in olden days. With the advent of newer stronger antibiotics, better USG and CT scan machines, percutaneous drainage was attempted.
Since the Splenectomy has already been advised, there is nothing much to suggest as the opinion must have been given by the Specialist.
Yet you can discuss the following with your treating Surgeon / Physician before you say yes to the Splenectomy:
-Blood culture and sensitivity.
-Antibiotic treatment with higher antibiotics.
-Drainage under the Laparoscopic guidance and splenectomy only if it fails / bleeding occurs. This way there is still a chance to save the spleen.
_ To discuss about the chance of Tubercular splenic abscess and the get further investigations for this. If positive Anti-tubercular treatment can be started and yet the spleen be saved.
Please discuss these point in detail and let me know their opinion.
May I please know the Specialty of the Doctor who gave you the decision for splenectomy..
Above answer was peer-reviewed by :
Dr. Bhagyalaxmi Nalaparaju
Hi Doctor,
We asked our doctor numerous times is there a way to save his spleen.. but he did not suggest any thing and said that... this is the only way to find what kind of treatment to be given after removing spleen... Our doctor is very adament to go for splenctomy. Dr. Vasudeva Pai from XXXXXXX Asia XXXXXXX
He also said.. you may also go for second or third opinion.. yet the final option is to remove spleen only...
That is why we were so confused... to go for splenectomy or not..!!
During the first week of Dec 2014 - for 15 days he was taking lovoflox + paracetamol.
After Parcutanious drainage he was taking Signoflame (3 times a day because of pain) and ceitle(some antibiotic - 9 tablets)
After removal of pipe.. he was just taking signoflame (2 - 3 tablets a day 10th XXXXXXX 2015 till 19th XXXXXXX 2015), then he took lovoflox 3 tablets for 3 days and stopped and asked to take only Dolo 650 3 times a day....
Please help us..
Regards,
XXXX
We asked our doctor numerous times is there a way to save his spleen.. but he did not suggest any thing and said that... this is the only way to find what kind of treatment to be given after removing spleen... Our doctor is very adament to go for splenctomy. Dr. Vasudeva Pai from XXXXXXX Asia XXXXXXX
He also said.. you may also go for second or third opinion.. yet the final option is to remove spleen only...
That is why we were so confused... to go for splenectomy or not..!!
During the first week of Dec 2014 - for 15 days he was taking lovoflox + paracetamol.
After Parcutanious drainage he was taking Signoflame (3 times a day because of pain) and ceitle(some antibiotic - 9 tablets)
After removal of pipe.. he was just taking signoflame (2 - 3 tablets a day 10th XXXXXXX 2015 till 19th XXXXXXX 2015), then he took lovoflox 3 tablets for 3 days and stopped and asked to take only Dolo 650 3 times a day....
Please help us..
Regards,
XXXX
Brief Answer:
Take Second opinion and discuss the possibilities.
Detailed Answer:
Yes, this is what I wanted to suggest.
It is always better to go for second opinion of another Surgical Gastroenterologist, I hope you have another at your place.
Also referred to the letter by Dr Pai on 2-1-15.
Please discuss the points with Dr Pai or another Surgeon and then take a decision.
Take Second opinion and discuss the possibilities.
Detailed Answer:
Yes, this is what I wanted to suggest.
It is always better to go for second opinion of another Surgical Gastroenterologist, I hope you have another at your place.
Also referred to the letter by Dr Pai on 2-1-15.
Please discuss the points with Dr Pai or another Surgeon and then take a decision.
Note: For further follow up on digestive issues share your reports here and Click here.
Above answer was peer-reviewed by :
Dr. Bhagyalaxmi Nalaparaju
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