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Is Painful Bowel Movement In A 2-year-old After Ruptured Appendix Removal A Serous Concern?

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Posted on Wed, 5 Jan 2022
Question: my daughter who is 2 years old had a ruptured appendix removed 6 days ago with extensive infection noted. Today she had pain with her bowel movement, which was loose and had streaks of blood and mucus throughout. Is this something I should expect or call her surgeon about?
doctor
Answered by Dr. Ramesh Kumar (2 hours later)
Brief Answer:
Surgical exploration and resection of appendix can be done.

Detailed Answer:

Hello,

Have seen your details. Most likely your case is a developing case of perotinitis. In most cases of peritonitis, a surgeon will remove appendix immediately and clean the inside of your abdomen to prevent infection. Treatments involve draining any pus or infection nidus from the abdomen and fighting the infection with strong antibiotics for several weeks. Parentral antibiotics post drainage of pus should be given to curb infection.
Pain is suggestive of ongoing infection and appendix need to be removed.

I think that few tests like
Total and differencial blood counts should be done to rule out infection.
ESR and CRP test have to be done,
Serum procalcitonon to be done,

As per protocol appendix should be removed asap with complete drainage of infection nidus to prevent perotinitis.
Neglecting the case may cause patient to land in sepsis and further into septic shock.
Thanks and feel free to follow up.
Above answer was peer-reviewed by : Dr. Nagamani Ng
doctor
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Follow up: Dr. Ramesh Kumar (11 hours later)
I do not believe you understood my question. Her appendix was already removed 6 days ago and was found to be ruptured with pus throughout her abdomen. I was asking about the blood and mucus in her stool that was present with her bowel movement yesterday and if that is something I need to call about or an expected finding
doctor
Answered by Dr. Ramesh Kumar (11 hours later)
Brief Answer:
If blood comes again then call the surgeon.

Detailed Answer:
Hello again,
I am sorry I failed to understand your query initially,
As the child is just 2 years old mucous in stools can be due to antibiotic etc used after operation or it can be viral gastroenteritis. However the alarming thing is that there is blood in stools.
So XXXXXXX answer is if the blood continues to be there in stools then just visit the nearest emergency.However few drops of it with mucuos like stools can be because of mild infection called enteritis which is usually self limiting in most of the cases.
Thanks
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Above answer was peer-reviewed by : Dr. Nagamani Ng
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Answered by
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Dr. Ramesh Kumar

Gastroenterologist

Practicing since :1986

Answered : 2906 Questions

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Is Painful Bowel Movement In A 2-year-old After Ruptured Appendix Removal A Serous Concern?

Brief Answer: Surgical exploration and resection of appendix can be done. Detailed Answer: Hello, Have seen your details. Most likely your case is a developing case of perotinitis. In most cases of peritonitis, a surgeon will remove appendix immediately and clean the inside of your abdomen to prevent infection. Treatments involve draining any pus or infection nidus from the abdomen and fighting the infection with strong antibiotics for several weeks. Parentral antibiotics post drainage of pus should be given to curb infection. Pain is suggestive of ongoing infection and appendix need to be removed. I think that few tests like Total and differencial blood counts should be done to rule out infection. ESR and CRP test have to be done, Serum procalcitonon to be done, As per protocol appendix should be removed asap with complete drainage of infection nidus to prevent perotinitis. Neglecting the case may cause patient to land in sepsis and further into septic shock. Thanks and feel free to follow up.