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What Causes Fever And Diarrhea After Appendix Operation?

Posted on Fri, 2 May 2014

Question: My brother, age 63 and healthy otherwise, had a burst appendix removed laparoscopically Tuesday at 9pm CST. He is still in the hospital. His temperature is fairly normal (97.5-99), incisions look good, no pain, but he has almost uncontrollably diarrhea, especially during the night. He is not on any pain medications, just an antibiotic. The doctor understandably won't release him due to this. It's a greenish, yellow color BM. Night before last he has almost forty episodes! Is this normal and what can we do? Thank you!!

Answered by Dr. Deepak Kishore Kaltari (21 minutes later)

Brief Answer: Possibility of Pelvic abscess to be rule out Detailed Answer: Hi Welcome to Healthcare-Magic Greetings of the day Dear Sir Post-operative period in case of ruptured appendicitis is very important. If the following criteria are fulfilled there is no much cause for concern 1. Absence of fever 2. Absence of significant abdominal pain 3. Absence of erythema/redness or disacharge from wound 4. Appetite returned back to normal. From your description other parameters okay. What needs to be considered is diarrhea. Presence of diarrhea in immediate post operative period , one should rule out the possibility of Pelvic abscess. Pelvic abscess which occurs due to accumulation of infected material in the pelvis can cause diarrhea. It can be rule out by Ultrasound examination. In my clinical practice , I d Ultrasound abdomen in any patient who presents post-operatively with diarrhea . I would also like the following additional history 1. Was any abdominal drain insereted during Surgery 2. Is he taking orally adequately. I would suggest you to discuss the possibility of Pelvic abscess with the treating Surgeon. If it is ruled out by Ultrasound and there is no blood in stools then there is no cause for concern. Other possibility of Loose motion is antibiotic induced diarrhea . If your brother is taking orally, giving Probiotics and addition of Metronidazole will provide the much need relief. Do discuss it with the operating Surgeon. Do get back to me if you need any further assistance, will be glad to assist you. Wishing your brother speedy recovery. Take Care Best Regards Dr Deepak Kishore MBBS,MS,MCH Consultant Surgeon

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

Follow up: Dr. Deepak Kishore Kaltari (11 minutes later)

Thank you for the excellent advice. His appetite is not good but it's because he's afraid to eat more than anything, I believe. He has only been given liquids up until this morning, jello and broth. Otherwise he has none of the other concerns you listed. He did not have any type of drain in his abdomen when he came out of surgery. Should we 'insist' on an ultrasound or give it another day, since no fever or pain or incision issues? P.s. antibiotic is intravenous Thank you!

Answered by Dr. Deepak Kishore Kaltari (15 minutes later)

Brief Answer: Recommended to get Ultrasound Detailed Answer: Hi Continued use of antibiotic in presence of pelvic absence there may be absence of fever. So always advisable to get Ultrasound abdomen done to rule out abscess. Ultrasound is non invasive and easy to carry out. Take care Best Regards Dr Deepak

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

Follow up: Dr. Deepak Kishore Kaltari (41 minutes later)

Will do! His doctor will be coming to see him in the next few hours. We GREATLY appreciate the knowledgable, thoughtful advice!! I will email an update later today! Thanks again!!

Answered by Dr. Deepak Kishore Kaltari (1 minute later)

Brief Answer: Take Care Detailed Answer: Hi Brother. Thanks Take Care Kindly keep me updated. Regards Deepak

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