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How can abdominal pain post AAA repair be treated?

DOCTOR OF THE MONTH - Sep 2017
Sep 2017
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Answered by

Pulmonologist
Practicing since : 2008
Answered : 13006 Questions
Question
My 89 year old Godmother had repair of an AAA two years ago. She has oxygen dependent COPD, lives independently now but realizes this is not safe and is considering moving into a facility. I am a nurse. Her doctors nurse makes home visits due to her home bound status. She has high anxiety for which she takes Xanax 1mg. Daily in 2divided doses. She is having a debiliting pain in the xiphoid area that occasionally is aided by Xanax or the placebo effect. She is unsure. Her medical records from 2hospitalizations indicate a “large hiatal hernia” that mysteriously did not show on the portable X-ray she recently had at home. It is not gallbladder according to my aunt and her visiting nurse and there are no stones present. Auntie XXXXXXX stated that after the AAA repair, the surgeon told her “things may not be exactly in the same place as preoperatively because if was difficult closing and placing organs back under the emergency circumstances. So my question is where do we go from here and what test do we ask the doctor to perform at this point? The sensation doubles her over until it passes. No N/V. Could she have another AAA brewing. Pain is always in the front.

Thank you for your thoughts. Signed, bewildered
Tue, 29 May 2018 in Lung and Chest disorders
 
 
Answered by Dr. Kaushal Bhavsar 58 minutes later
Brief Answer:
Better to consult gastroenterologist and psychiatrist.

Detailed Answer:
Thanks for your question on Healthcare Magic.
I can understand your concern.
I don't think it is AAA (abdominal aortic aneurysm) related pain.
AAA related pain is mostly on back side, not front.
Since she is having anxiety and large hiatal hernia, possibility of GERD (gastroesophageal reflux disease) related pain is more likely.
So better to consult gastroenterologist for GERD.
Also consult psychiatrist for anxiety management. Appropriate anxiety management is must to control GERD symptoms.
She should try conservative treatment for GERD as follows.
1. Pantoprazole and levosulperide combination on empty stomach twice daily.
2. Avoid hot and spicy food. Avoid junk food.
Please let me know if she is taking any antacid at present.
I will be happy to help you further. Wishing good health to your grandmother. Thanks.
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