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Dr. Andrew Rynne

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Constipated, losing weight, felt lump behind belly button. Diagnosed with enlarged spleen. Treatment?

Answered by
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Dr. G.Srinivasan

Urologist

Practicing since :1991

Answered : 1414 Questions

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Posted on Thu, 14 Feb 2013 in Digestion and Bowels
Question: My Father has been in quite a lot of pain for 5 weeks now. He is hardly eating and has constipation and as a results he has lost quite a bit of weight. His family Doctor diagnosed an enlarged spleen and said he would need an ultrasound, but it would take some weeks. In the meantime the pain got so severe that he had to go to emergency and a Doctor there said he needed an urgent CT scan. As we are in the UK and the health system is terrible due to lack of money, he is still awaiting this urgent scan almost three weeks later. He will finally have it next week. However yesterday he felt a hard lump behind his belly button and it stinks. What is going on?
doctor
Answered by Dr. G.Srinivasan 4 hours later
Hi,
Welcome to XXXXXXX
I noted the detailed history.
In my opinion, he either has umbilical hernia that has become obstructed or a secondary deposit form a primary tumor elsewhere( most probably bowels)
He needs , more importantly, clinical examination to look for features of intestinal obstruction, where the history would be constipation, not passing flatus, vomiting and abdominal distension.
Examination would reveal abdominal distension, lack of bowel sounds and an empty rectum on rectal examination . CT is not mandatory for clinical diagnosis and a ER SURGEON should be able to help him even without a CT.
I would suggest to see a surgeon at the ER asap.
Hope this helps. Kindly write back for doubts if any.
BEST REGARDS
DR GS
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Follow up: Dr. G.Srinivasan 15 hours later
Dear Dr.GS,

Thank you very much for your answer.

I forgot to mention yesterday that he has had no vomiting and his abdomen is not distended. He does however have a lot of flatulance and seems to be constantly burping! He gets very full after only eating a small amount and is very fatigued.
His pain is on the left handside under his ribcage. After doing some online research last week, I found that one of the causes of an enlarged spleen was Hodgkins lymphoma which my Father has. He was able to see his family Dr. today and he said that my Father most likely has an infection in his belly button and has prescribed antibiotics and drops.

Does this information lead you to change your opinion or do you still maintain your original diagnosis?

Thank you in advance.

Kind Regards
XXXXXXX
doctor
Answered by Dr. G.Srinivasan 5 hours later
Hi Ms. XXXXXXX

Welcome back. Thanks for the additional information.
The enlarged spleen alone should not give rise to loss of appetite, burping and excessive flatulence. I suspect something in his stomach like gastritis/ ulcer/ lymphoma causing the above symptoms.
From the opinion of your family doctor, i realize that he has infection of the belly button, called OMPHALITIS.
Since there is no abdominal distension or constipation, i would rather wait for a while to see if his belly button problem gets better in the next few days, with the given treatment.
If CT scan does not reveal anything significantly, i would recommend a GASTROSCOPY to look at the stomach.
Hope this helps.
Best regards
DR GS

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. G.Srinivasan 25 hours later
Dear Dr.GS

Thank you very much for your help and advice as My Father, Mother and I are very grateful for your opinion. When my Father goes for his scan he will definitely mention everything you have written. I have printed out all your replies.

If I require any further advice from you after my Fathers scan, I will definitely be in touch. However if I don't need to contact you then I wish to convey my thanks to you yet again.

All the best.

Best regards XXXXXXX
doctor
Answered by Dr. G.Srinivasan 3 hours later
Hi Ms. XXXXXXX

Welcome back.

I am happy to read your words on my appreciation. This is the best thing about my profession, helping somebody who needs it, even from a remote place.
Probably internet would be within the top 10 inventions of the century!
I wish him best health and best wishes for your family.

Regards
DR GS



Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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