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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Issues With Post Surgical Infections, Need Thoughts For Second Opinion

Male 39. Acute/hemorragic pancreatitis in early April. Surgery to remove gallbladder and most of the pancreas in May. Issues with post surgical infections which were resolved with antibiotics and a second surgery. Around June 18, liver enzyme numbers spiked dramatically. Lots of tests were done because the dr suspected a blockage in the bile duct, despite the t-tube draining well. Tests included a failed ERCP, EUS, CT and abdominal ultrasound. The only thing any of these revealed was a slightly swollen duodenum. June 20, he had a slight fever. Blood cultures t-tube cultures were done. Showed he had VRE in his bile. Linezolid was started and the enzymed numbers immediately went back to normal. June 27 the liver numbers spiked again after several days on Meropenem, which is known to cause liver issues, including abnormal results for ALT, AST and ALP. June 28, the numbers started going back down, but the dr is still determined that there is a blockage, now he thinks the slightly swollen duodenum is the issue has ordered a rendezvous procedure, despite all the evidence that the numbers are highly unlikely to be due to a blockage of any kind, since they keep going back down. Especially highly unlikely to be because of blockage due to the return to normal after treatment for VRE. Patient is reluctant to undergo yet another completely unnecessary procedure and would appreciate a second opinion.
Tue, 18 Oct 2011
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  User's Response
's  Response
hello to hcm,
the patient is under giong very compleicated panceatitis ang iner inflamation.besides the treatmrnt in use,there may perhaps be giood use if homeopathic medicine may alternative with western medinicine.to aid remedy ischelidonium@+berberis vulgg+pure olive oil+lomon juice.both oil and lemon juice may be taken1teaspoon ful and 10 drops of homeo remedies.
homeo remedies can be had from home pharmacy.R72 RECKWEG GERMANY
DR.MOHSIN MADNI
madni66@saudia.com

General & Family Physician Dr. P. Mahesh's  Response
Hi,
welcome to HCM,
If the gastroenterologist is suspecting blockage there has to be reason for him to suspect that, based on investigation reports. Probably the patients serum bilirubin is not coming down or gradually increasing. Thickening of duodenum may cause blockage of biliary tract drainage by squeezing effect on the common bile duct at the point where it enters the duodenum.
Wishing the patient all the best.
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Issues With Post Surgical Infections, Need Thoughts For Second Opinion

hello to hcm, the patient is under giong very compleicated panceatitis ang iner inflamation.besides the treatmrnt in use,there may perhaps be giood use if homeopathic medicine may alternative with western medinicine.to aid remedy ischelidonium@+berberis vulgg+pure olive oil+lomon juice.both oil and lemon juice may be taken1teaspoon ful and 10 drops of homeo remedies. homeo remedies can be had from home pharmacy.R72 RECKWEG GERMANY DR.MOHSIN MADNI madni66@saudia.com