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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Child has abdominal pain, nausea, vomiting and decreased appetite. Had Appendectomy done. Suggestions?

Hi, My daughter just had an Appendectomy performed 11 days ago. Her appendix perforated in her, she had a PICC inserted through the arm and is being treated with Zosyn 3 times daily. It has been only 5 day since she was released and felt great for about 3 days returned to most of her normal activities,but for the past 2 days has started to complain and show some of the similar symptoms that caused us to diagnose her with appendicitis; Abdominal pain/Distention on the right lower quadrant and belly button area, Nausea, Vomiting of liquid mucus and a white bubble foam similar as to the foam spit in Acid re-flux, Constipation/ Diarrhea but comes out very little per stool and goes frequently and complains of cramping during this period, has the chills but body is warmer then usually has a constant temperature of 99.9 : 100.5, and greatly decreased appetite as well as fear of constant vomiting of food and pain in belly with a heavy cough in which she will complain that the belly will hurt at times. What I have researched and feel I have diagnosed could be of 3 things Peritonitis, Adhesion , and Irritable Bowel syndrome , with tests still needed to prove one of these theories correct. But based on your expertise, What do u feel needs or can be done to help and assess the current situation for best options? Beside going to emergency as it being the primary option on my to do list.
Sat, 23 Feb 2013
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General Surgeon 's  Response
Hi
As per your query,your daughter got operated for Appendicular perforation.Appendix got perforated and lead to peritonitis.After Appendicectomy,her abdominal cavity has to be washed with Normal saline to clean the peritoneal collection.Then,a drain has to kept from inside to drain the collected fluid outside.If the drain is not kept,fluid that is collected inside will get infected or pus might not be drained completely.
So,because of the infection inside,there is pain,vomiting and fever.As she is having distension in right lower quadrant ,there will be some collection at the right lower quadrant or lower abdomen.There will be mucus in stools due to rectal irritation by the pelvic collection.
Adhesions after surgery will lead to abdominal distension,vomiting and constipation.
Irritable bowel syndrome does not fit here.
Consult your Surgeon immediately and get a Plain x ray abdomen in erect posture to rule out intestinal obstruction due to adhesions and Ultrasound abdomen to rule out any Collection inside abdominal cavity.
Proceed as per the reports.
Wish her speedy recovery.
If you come back with above reports,i will clarify further.
Regards
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