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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Appendicitis, Loose BM, Abdominal Distention, Vomiting Bile Fluid. Had A Surgery. Was It Faulty?

hi, my brother had been admitted to hospital due to appendicitis and offered surgery straight away.he was asked if he have moved his bowels during post operation assessment and he told the attending doctor that he moved bowels but is quite loose.after more than 24 hours he was discharge as he was up and about.But the problems arise, on the night of his discharge when he developed vomiting of bile fluid and abdominal distention and he complained of feeling bloated.no foods are being retained if he tries to it.what do you think must have happened?was there a fault in his surgery?he is now readmitted and we were told that it maybe is a mechanical obstruction and need to have tube in his nose to drain the fluids in his abdomen.will my brother be in danger?
Sat, 8 Jun 2013
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General Surgeon,  's  Response
Hi ! From the history you have mentioned, it could be just that starting of oral food was early, and so there is persisting paralytic ileus due to which the present problems arose. It may get relieved of its own by conservative management.
One perplexing finding is of loose stool post opertively, which usually occurs due to any kind of peritoneal irritation to the colon. I am not sure, but there could be some fluid accumulation due to very many causes resulting in peritonitis which caused the secondary bowel obstruction. The vomiting of bilious fluid points to obstruction of the intestines. The treating surgeon is the best judge and he may go for some investigations like complete blood count, ultrasound abdomen, X ray abdomen in erect posture to exclude pathological processes in the abdomen. If diagnosed as a mechanical obstruction, he may be in need for a relook surgery in the hospital.
I wish him an early recovery.
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Appendicitis, Loose BM, Abdominal Distention, Vomiting Bile Fluid. Had A Surgery. Was It Faulty?

Hi ! From the history you have mentioned, it could be just that starting of oral food was early, and so there is persisting paralytic ileus due to which the present problems arose. It may get relieved of its own by conservative management. One perplexing finding is of loose stool post opertively, which usually occurs due to any kind of peritoneal irritation to the colon. I am not sure, but there could be some fluid accumulation due to very many causes resulting in peritonitis which caused the secondary bowel obstruction. The vomiting of bilious fluid points to obstruction of the intestines. The treating surgeon is the best judge and he may go for some investigations like complete blood count, ultrasound abdomen, X ray abdomen in erect posture to exclude pathological processes in the abdomen. If diagnosed as a mechanical obstruction, he may be in need for a relook surgery in the hospital. I wish him an early recovery.