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What causes severe abdominal pain inspite of having a history of draining the ascitic fluid every 3 weeks?

Feb 2018
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General Surgeon
Practicing since : 1984
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Hello Doctor. I have developed at times quite sever abdominal pain in last week. It is allover my belly, specially bad sitting and very worst standing. Least amount of pain when lying down on sides. But it does hurt all the time. As stated in my history I have ascites. On water pills for that and getting it drained every three weeks. Right now only moderate fluid amount. I'm guessing around 2gallons or a bit more. Also I got pretty big bellybutton hernia, about fist sized. What could be reason for this abdominal pain? Any ideas? Awaiting an answer. Thank you.
Posted Wed, 26 Mar 2014 in Abdominal Pain
Answered by Dr. T Chandrakant 3 hours later
Brief Answer: can be peritonitis Detailed Answer: Hi. Gone through the Medical History and Current Medication you provided. Your history of draining the ascitic fluid every 3 weeks worries me. There is a chance of an infection of the peritoneal cavity as it is breached every three weeks. This is called peritonitis and is a reason for sever pain all over the belly. It worsens on sitting or standing because the fluid inside shifts to touch the very sensitive peritoneal covering of the abdomen. Hurts all the time. Big bellybutton hernia of the size you described can not cause this pain, unless there is obstruction of intestine, which would have given vomiting, distension and other signs, which you do not have. I would advise such a patient to get admission, Intravenous antibiotics, diagnostic ascitic tap for analysis and culture and sensitivity.
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