Sign-in to Ask A Doctor - 24x7
OR
Sign in with Google
What Causes Abdominal Guarding, Nausea And Constipation When Diagnosed With Epiploic Appendagitis?
Question: I had an appendectomy a year ago. And just recently was diagnosed with epiploic appendighitis a month ago. They did another scan two days ago and it hadn't gone away like it should. Well now I am having TEXTBOOK appendicitis symptoms. Guarding, jumping, nausea, constipation, cold sweats. No low grade fever. I keep demanding a consult up to my room bc I've been in agony for the past four hours. In your opinion could this be the stump? Could it be surgical? Because right now nothing is touching the pain. Part of me wants to go to the ER downstairs and get seen but of course that's against hospital protocol. Please tell me what you would think it is and what your course of action would be.
Brief Answer:
As detailed below.
Detailed Answer:
Hi.
Thanks for your query.
To recapitulate: Female/26 - appendectomy a year ago - epiploic appendagitis a month ago - scan 2 days ago - not gone as it should have - NOW textbook symptoms of appendicitis - guarding, jumping, nausea, constipation, cold sweats - no fever - asking for a consultant as have been in agony for the past 4 hours - ? stump - ? surgical - can not go to ER as it is against hospital protocol -
Since you have symptoms as mentioned there has to be a reason and may be one of the following:
Stump appendicitis as you have mentioned , although it is rare.
Epiploic Appendigitis not yet settled.
Since you are a female of 26, gynecological reasons also should be thought about and ruled out by examination by a Gynecologist and Ultrasound or better to go for contrast enhanced CT scan of the whole abdomen.
Stone in the right ureter with urinary tract infection can mimic.
Infected or inflamed lymph node mass.
Typhlitis that is inflamed cecum.
I would advise the following in such a situation.
Gynecologist's opinion as discussed.
General Surgeon to have clinical evaluation, examination.
Tests of blood, stool and urine.
CT scan of the abdomen as mentioned.
Re-evaluation and re-thinking should be done to get the exact cause.
Please also discuss about the role of diagnostic Laparoscopy in such a case if the investigations are not correlated with the symptoms and signs.
I hop[e you have no missed periods or any other gynecological problems.
I hope, this answer helps you, please feel free to ask for further relevant queries if you feel that there is a gap of communication.
As detailed below.
Detailed Answer:
Hi.
Thanks for your query.
To recapitulate: Female/26 - appendectomy a year ago - epiploic appendagitis a month ago - scan 2 days ago - not gone as it should have - NOW textbook symptoms of appendicitis - guarding, jumping, nausea, constipation, cold sweats - no fever - asking for a consultant as have been in agony for the past 4 hours - ? stump - ? surgical - can not go to ER as it is against hospital protocol -
Since you have symptoms as mentioned there has to be a reason and may be one of the following:
Stump appendicitis as you have mentioned , although it is rare.
Epiploic Appendigitis not yet settled.
Since you are a female of 26, gynecological reasons also should be thought about and ruled out by examination by a Gynecologist and Ultrasound or better to go for contrast enhanced CT scan of the whole abdomen.
Stone in the right ureter with urinary tract infection can mimic.
Infected or inflamed lymph node mass.
Typhlitis that is inflamed cecum.
I would advise the following in such a situation.
Gynecologist's opinion as discussed.
General Surgeon to have clinical evaluation, examination.
Tests of blood, stool and urine.
CT scan of the abdomen as mentioned.
Re-evaluation and re-thinking should be done to get the exact cause.
Please also discuss about the role of diagnostic Laparoscopy in such a case if the investigations are not correlated with the symptoms and signs.
I hop[e you have no missed periods or any other gynecological problems.
I hope, this answer helps you, please feel free to ask for further relevant queries if you feel that there is a gap of communication.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
I had a hysterectomy like three months ago so i doubt its gynological. Im so scared and just want to get out of pai. XXXX
Brief Answer:
Noted
Detailed Answer:
Oh, this is an important additional information.
Hence another possibility of intestinal obstruction can be considered, a small possibility.
Please ask for early examination and investigations
Noted
Detailed Answer:
Oh, this is an important additional information.
Hence another possibility of intestinal obstruction can be considered, a small possibility.
Please ask for early examination and investigations
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
They are sending up someone to consult soon. Should i push for a lap?
Brief Answer:
As detailed below.
Detailed Answer:
Push for the investigations I mentioned.
Lap is the one of the best diagnostic modality if everything else is not diagnostic or does not give give diagnosis with certainty. Discuss about this option too as it is diagnostic as well as therapeutic in some cases.
As detailed below.
Detailed Answer:
Push for the investigations I mentioned.
Lap is the one of the best diagnostic modality if everything else is not diagnostic or does not give give diagnosis with certainty. Discuss about this option too as it is diagnostic as well as therapeutic in some cases.
Note: For further inquiries on surgery procedure and its risks or complications book an appointment now
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Answered by
Get personalised answers from verified doctor in minutes across 80+ specialties
