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Did hysterectomy and lap chole. Having abdominal bruising, diarrhea and fever. What would be the reason?

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General & Family Physician
Practicing since : 2009
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Hx of total hysterectomy after years of endometriosis, PCOS. 3 miscarriages. Most recently, lap chole in May 2013 (also acute hepatitis and pancreatitis due to 26 stones in GB). Since then, abdominal bruising, diarrhea, fever (low grade). Also exhaustion to the point of sleeping 40 out of 48 hours.
Posted Wed, 30 Oct 2013 in Vaginal and Uterus Health
Answered by Dr. Luchuo Engelbert Bain 55 minutes later
Brief Answer:
Complete review by an internist first required

Detailed Answer:
Hi and thanks for the query,

Thanks for the detailed past medical history you have offered. Low grade fever, diarrhea and exhaustion deserve particular attention. It would be interesting however to have a better idea of how long you have been having diarrhea, low grade fever and this bruising. Any family history of similar symptoms, heart disease could be helpful.

Potassium level at 2.9 is slightly below the lower margin. This could be explained by the diarrhea. Exhaustion shall deserve a complete blood count to be down, to know the hemoglobin level, to exclude anemia, a common cause of fatigue. The state of the liver function is important to be reevaluated. An affected liver could have as manifestation, easy exhaustion. An abdominal ultrasound shall give us a good state of the gall bladder, the sizes of the stones , any other possible complications like fluid collection in the abdomen, and guide management. A chronic infection requires to be excluded. This could be translated by the low grade fever noticed. It could be important to know if any one has been around you coughing for a long time, or if you cough. Tuberculosis could have atypical presentations as such.

A complete panel with measurement of blood platelets, clotting profile, Vitamin K levels in blood, and liver function tests are required to know the reason of the easy bruising. You might need a colonoscopy to evaluate and understand better any possible cause of diarrhea that could be arising from the colon.

I suggest a complete clinical review by an internist. Tests, including some that I have proposed could be initial steps to guide diagnosis and treatment. Feel free asking follow up questions in case you got specific concerns. Thanks and kind regards as I wish you good health.

Bain LE, MD
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