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Dr  Jones
Dr Jones, Board Certified MD
Category: Medical
Satisfied Customers: 3907
Experience:  MD-Post graduation.10 years in handling and helping patients.Expert in emergencies and diagnosis.
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E infection after laproscopic bowel resection. I have had 5

Resolved Question:

E coli infection after laproscopic bowel resection. I have had 5 rounds of antibiotics and I am still infected. CT scan is OK, I don't know what to do anymore. Surgeon doesn't seem to concerned. I can't take anymore. Visiting nurse comes everyday and I am clean.Please help me
Submitted: 5 years ago.
Category: Medical
Expert:  Dr Jones replied 5 years ago.
Dr Jones :

Hello

Dr Jones :

Welcome to justanswer.

Dr Jones :

Was stool culture done?

Customer:

In the hospital 3 months ago, no c diff

Dr Jones :

What are current symptoms?

Customer:

oozing at wound site, pain and inflammation surrounding the site

Dr Jones :

Where is the wound site?

Customer:

it actually feels electrically charged when it is discharging. it is on the right side under the breast near rib cage.

Dr Jones :

Is pus oozing out through wound site?

Customer:

yes

Customer:

When do I hit the accept button? I am not really good with computers

Dr Jones :

Please dont hit accept till we have finished discussion.

Dr Jones :

I will tell you when to hit it.

Dr Jones :

Is the discharge coming out through a sinus or fistula?

Customer:

No fistula was seen on CT scan, if sinus means the hole that is from the surgery, yes it comes out of there.

Dr Jones :

Was contrast or dye installed in the opening through which pus comes out during CT scan ?

Customer:

no, the contrast was done through the arm

Dr Jones :

Then there are chances that fistula or sinus and its intra-abdominal extent would be missed.

Dr Jones :

In view of your symptoms and antibiotics not responding formation of such fistula is very likely.

Customer:

what is my next move? Would infectious disease dr help. If it is fistula, what does that mean

Dr Jones :

Such fistulas are very well known to persist even with good antibiotics.

Dr Jones :

Next step would be to get a fistulogram done to see internal extent of the tract.

Dr Jones :

Fistula is abnormal linear tract communication with viscous organs.This tract is commonly infected.

Customer:

Is that done in a hospital?

Dr Jones :

Its common to have localised collection of pus underneath such fistulas.

Dr Jones :

Yes,its done in radiology department of hospital.

Customer:

what t

Customer:

what type of dr should I see? I don't even know if I want to go back to my surgeon

Customer:

Would intravenous antibiotics help and does that fistulogram require being put out?

Dr Jones :

Actually a general surgeon is a person who can handle this.Since your current surgeon has not taken any action I guess you need to consider a second opinion.

Customer:

OK. Is there anything else I should ask that you can think of? I can't even think anymore

Dr Jones :

Intravenous antibiotics can surely help but first fistula and underlying pus collection needs to be taken care of or otherwise only taking antibiotics will not prove helpful.

Customer:

Are we done now?

Dr Jones :

I guess thats all.Do consider taking a second opinion or discuss about the things I have suggested with current surgeon so that he/she can take further steps.If not . then you can go ahead with second opinion.

Dr Jones :

Please ask if there are doubts.Regards.

Dr Jones :

If you dont have doubts, then we are done.

Dr Jones :

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Customer:

Yes I feel your information has been helpful. Thank you and how do I print out all of your answers

Dr Jones :

All these answer have been already emailed to you.Or you can copy paste this to word document and get it printed.

Dr Jones :

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