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Had appendix removal, abdominal pain, CT scan showed infection in abdominal cavity, vaginal drainage. Any ideas?

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General Surgeon
Practicing since : 2008
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Hello Doctor,
A friend of mine recently had her appendix removed (approx. 7 days ago) it had not ruptured, but was inflammed and had a lap appy. Discharged a day later from the hospital. She has been having some post op pain, lack of appetite, but over the past 4 days, her pain has been severe, can't keep anything down, and she did go in to the ED on Wed. noc. CT scan indicated an infection in her abdominal cavity and she was admitted for antibiotic therapy. She just called me a little while ago, very upset, and said that she passed a very large amount of pus from her vaginal opening. (She's had a Hysterectomy in the past) the nurses are baffled, I questioned if her surgeon who performed the appy and who is now following her in the hospital had considered going in to drain/suction the infection from her gut....she said he didn't feel it was necessary to do that. Nobody has any idea of why she's passing drainage from her vaginal mention of abcesses in her gut from the CT scan....have you ever heard of anything of this nature....passing abdominal pus thru the vaginal opening? Thank you
Posted Wed, 19 Sep 2012 in Abdominal Pain
Answered by Dr. Grzegorz Stanko 1 hour later

Thank you for the query.

To understand how pus from abdomen gets into vagina it is necessary to imagine that basically vagina has a communication with abdominal cavity. It is possible as the ovaries and oviducts are in some distance, and the oviducts are basically open so in some cases, blood from uterine can appear in abdominal cavity, and the pregnancy can appear in abdomen cavity as well (we call it ectopic pregnancy).

After a hysterectomy, when uterine is removed from abdominal cavity, the only thing that is left is closed with stitches vagina. As it was stitched, it can get easily open by some pathologic process. And abdominal abscess is such process. The inflammation is some kind of destructive process, which destroys tissue by tissue and sometimes leads outside the body. That`s what has happen to your friend.

Every intra abdominal abscess should be either drained with percutaneous abscess drainage or with classic surgery as abscess is a life-treating condition.
If CT says that there is the infection, it means that there was an abscess found!
In my opinion she should have surgery right away.

Hope this will help. Feel free to ask further questions.
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