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What Causes Abdominal Swelling And Fatigue After A Radical Cystectomy?

Posted on Tue, 25 Jul 2017

Question: Dad has paralytic illeaus after radical cystectomy (removal of bladder and prostate). He has swollen tummy, on drip, morphine and tube up nose and down throat. It's day 5 post op only sipping water. Doctors say they will see what it is like in a few days, if not resolved after 2 weeks may need operation but is too weak. Any advice appreciated. What can help? What could be the duration? Will it resolve itself on its own?

Thank you

Answered by Dr. Bhagyesh V. Patel (1 hour later)

Brief Answer:
Post operative paralytic ileus has many etiology factors and management .

Detailed Answer:
Hello dear
Thanks for using Healthcaremagic.com
I have evaluated your query thoroughly .

* Post operative paralytic ileus has many reasons & different management .

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

1. Swollen tummy started from which day after surgery , how is it increasing or
same as from beginning .
2. Passing flatus , stool anytime after operation .
3. Reports of ultrasound , x-ray , laboratory if available very important to co relate
for proper evaluation of the case in depth .
4. abdominal pain , fever .
5. Other systemic illness as diabetes , heart problems .

Awaiting for your response .

Regards .

Above answer was peer-reviewed by : Dr. Kampana

Follow up: Dr. Bhagyesh V. Patel (9 hours later)

His swollen stomach is no better. Still on drip. He has not moved his bowels or wind. Took him off the morphine. He is having scan tomorrow so no results from that as yet. He is in severe pain. What do you think is causing this? Is this common after radical cystectomy? Will it resolve itself or do patients require more surgery? Also how many days after op could this go on for? He had very high blood pressure of 210, the nurses gave him something to help this. Some form of liquid but no tablets as he can't keep anything down. He has no other medical problems apart from colitus and I think he suffers from swollen tummy for many years.

Answered by Dr. Bhagyesh V. Patel (4 hours later)

Brief Answer:
All questions answered in details below .

Detailed Answer:
Hello
Thanks for the details .

* Most probable reason is electrolyte imbalance with other factors as old age,
previous tummy weakness adding upon for his condition .
* It is common in many such types of cases involving complex pathology .

* If it does not resolve after adequate trial of conservative treatment ( which is
going on right now ) , then surgery is required further .
* It goes on for uncertain period after surgery , there are no definite cut off lines ,
because many parameters work behind that .

Hope this will help you .
Would love to revert back with latest scan report and if possible old or new lab
tests results .
Wishing him fine recovery from the same .
Regards dear , take care of him .

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Above answer was peer-reviewed by : Dr. Yogesh D