After he had the rupture appendix removed, the surgeon did not take the bacteria that had leaked, therefore his abdomen is swollen, has the lining infected, its already 8 days,the doctor has given him antibiotics so the bacteria doesn't grow but has not done anyting to removed this bacteria still in the stomach wall, stated the some of the bacteria amount is not large enough to remove it, wants to release him as it.
what are the dangers of him to have more contaminated areas? the swollen stomach still is as the first time he looks like he 7 months pregnant.
If an appendix ruptures, it can lead to a serious condition called peritonitis, which is an inflammation of the peritoneum, the tissue that lines the inner wall of the abdomen and covers and supports most of your abdominal organs. Peritonitis is usually caused by infection from bacteria or fungi that enter through a rupture in the gastrointestinal tract, such as a ruptured appendix.
When bacteria leak into the abdominal cavity, it can lead to the formation of an abscess (a pocket of pus) or diffuse peritonitis (infection throughout the abdominal cavity). If the infection is not adequately managed, it can spread and lead to sepsis, a life-threatening response to infection, which can result in organ failure and death if not promptly and properly treated.
The usual treatment for an abdominal abscess or peritonitis following appendectomy includes:
- Antibiotics: To treat the underlying infection.
- Drainage: If an abscess has formed, it might be necessary to drain it. This can often be done with a needle through the skin (percutaneous abscess drainage), which is guided by imaging such as ultrasound or CT scan.
- Surgery: In cases of diffuse peritonitis, additional surgery may be needed to clean out the infection from the abdominal cavity.
The fact that the abdomen is still swollen and appears as distended as it was initially is concerning. It suggests that the infection and/or inflammatory response has not resolved. This can be due to inadequate source control, which means that the focus of infection was not adequately addressed.
Here are some potential dangers if the infection is not adequately managed:
- Spread of infection: Bacteria can continue to spread throughout the abdominal cavity and possibly enter the bloodstream.
- Formation of additional abscesses: The infection can lead to the formation of more abscesses that can further compromise abdominal organs.
- Sepsis: This is a systemic response to infection that can lead to shock, organ failure, and death.
- Adhesions: Infection and inflammation can cause tissues to stick together, leading to adhesions that can cause chronic pain and bowel obstructions.
- Impaired healing: Ongoing infection can impair the healing of surgical sites and may lead to wound complications, including dehiscence (opening of the wound).
In a situation where there is a disagreement with the medical team's decision or a lack of progress, the following steps could be taken:
- Discuss concerns: Speak directly with the treating surgeon and express concerns about the lack of progress and request detailed reasoning behind the treatment plan.
- Ask for a case review: Most hospitals have a system for case reviews or patient advocates who can be approached to ensure the patient’s concerns are being addressed.
- Seek a second opinion: Request a consultation with an infectious diseases specialist or another surgeon for a second opinion on the management of the condition.
- Transfer of care: If it is felt that the care provided is inadequate and the patient's condition allows, it might be necessary to consider transferring care to another facility where appropriate treatment can be given.
Hope this helps.