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Dr. Andrew Rynne

Family Physician

Exp 50 years

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Are TPN and lipids effective at treating appendicitis gangrene?

Answered by
Dr. Bhagyesh V. Patel

General Surgeon

Practicing since :1999

Answered : 13568 Questions

Posted on Tue, 21 Aug 2018 in Lump
Question: Appendicitis gangrene why would they give TPN and lipids
Answered by Dr. Bhagyesh V. Patel 26 minutes later
Brief Answer:
Many reasons for TPN .

Detailed Answer:

Hello and Welcome to ‘Ask A Doctor’ service. I have reviewed your query and here is my advice.

* The need of Total Parenteral Nutrition has many requirements as

- Septic condition .
- Paralytic ileus or obstruction condition after surgery .
- Severe electrolyte imbalance .
- Severe vomiting , inability to tolerate liquids by mouth .
- Others .

Kindly provide further details so that I can answer your query completely .

1. What are the current symptoms you have .
2. After surgery , within 5 days , doctor had started to give orally anything to
drink or eat .
3. Systemic features as fever , vomiting or others .
4. Details of urination and bowel movements .
5. If possible and available reports of before surgery , after surgery .

Hope I have answered your query. Let me know if I can assist you further.

Above answer was peer-reviewed by : Dr. Nagamani Ng
Follow up: Dr. Bhagyesh V. Patel 48 minutes later
Did you get the picture I sent of his appendix will they biopsy it doctor said that if he had waited 24 to 48 hours he would have been dead my biggest concern is could it be cancer
Answered by Dr. Bhagyesh V. Patel 5 minutes later
Brief Answer:
Follow up .

Detailed Answer:
Welcome for the follow up .

Sorry , but I have not received any picture of yours till now .

Cancer is not the concern in any form in case of appendicectomy procedure , so do
not get panic for this .

Wishing him fine recovery .
Welcome for further guidance .

Regards take care .
Above answer was peer-reviewed by : Dr. Nagamani Ng
Follow up: Dr. Bhagyesh V. Patel 5 minutes later
He suffers with PTSD following 18 months in Iraq where he also has a TBI. He thought he had the flu like I have but didn't tell me about the abdominal pain I am a hospice nurse now but have also done med surg too I have never seen anyone receive TPN post op and have not been able to catch the doctor when he comes to visit any information you could help me with would be much appreciated

I can't figure out how to send you a picture of his appendix
Answered by Dr. Bhagyesh V. Patel 5 hours later
Brief Answer:
follow up .

Detailed Answer:

* As a nurse you must be knowing all details of condition of the patient before
surgery , operative notes as well as all documents study are necessary to
precisely evaluate the case .

* In absence of all of these I can figure out that

- Currently patient is on TPN means patient`s vital condition as well as intestines
are not okay .
- Patient is fighting against major infections in the system which can be pre
existing or flare up after surgery .
- Patient needs intensive therapy and close observation with team of doctors
including intensivist , gastrosurgeon , physician and others .

* There is an option to upload picture / reports on this page. You can utilize it to upload picture. Alternatively you cam mail it to YYYY@YYYY with subject as "Attn: Dr. Bhagyesh V Patel.

Hope I have answered your query.

Take care

Dr. Bhagyesh V. Patel, General Surgeon
Above answer was peer-reviewed by : Dr. Prasad

The User accepted the expert's answer

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