The Never Healing Abscess

Ive had this abscess ever since my last resection in sept.  The first round I was rushed to the ER where it decided to explode, it was then opened up completely cleaned out, and I was hooked up to this lovely machine called a wound VAC. It seemed to heal up completely, but a couple of weeks later it was back again! Horray.  It was opened again but because I didnt have insurance this go around, I didnt get a wound VAC, and I was told just to do a wet to dry dressing.  Heres the problem, it heals around, but not from the bottom up, so its still just as deep as it was to begin with but MUCH smaller in diameter.  My surgeon said its because of my weight, which I wont deny, I did gain 45lbs from being on 100MG of pred for over 5 months, plus the taper off.  Of course I cant just drop the 45lbs in a day, a week, or even a months time...its a long process, but is there anything I can do to help it help from the bottom up faster.  Its so frustrating, theres a lot of discharge from it, sometimes dark brown or black, I was worried it was actually wastes from my stomach but my surgeon said if it wasnt more than a liter of discharge he highly doubts my intestines tunneled into my abscess.  Im supposed to only change the dressing twice a day, but I find myself changing it every 2 hours because it leaks through, I have to wash my bed sheets every morning because during the night it leaks horribly, Im worried about work, I start back on Saturday, hopefully it doesnt leak through my work clothes.  Blah!  Any advice or has anyone ever gone through this before?

Oh, Mag, that's terrible. I'm so sorry you've had to endure this.

This disease keeps getting crueller, doesn't it?

When I had an abscess drained (the second time around,also) they left a drain tube in for about three weeks with a drain bag that I strapped to my leg so you could hide it under my clothes. The tube had sort of a perforated balloon at the end so it wouldn't slide out, but would drain what was at the bottom. Then finally they did a CT scan that showed all the muscle had closed in around it and that's when they took it out.

The abscess is right above my bellybutton (the fattiest part of my stomach), my surgeon never mentioned that I could turn into a fistula, but he did say that eventually  hernia would develop there.  Ive been getting B12 shots every month.  I clean it out with saline and I use Kerlix gauze to pack it, and then I put a sterile pad over top of that and then tape it.

I have had the same problem as you.  My abcess appeared in October of 07 and I am still having surgery for it I am going in for my 6th in a few weeks.  I drain all the time and it never heals.  It drives my crazy.  The doctors tell me that this is a common problem and that it takes time. First I was told it would only take a few months to heal and stop draining I am now a year and a half later I am still draining!  I wear sanitary pads 24/7  they help me feel more comfortable going in public and not being afraid of the draining, which sucks.  If you find an answer to make it all go away let me know.  I can tell you this you will get used to it as much as it stinks to have it. 

Well I finally went to the ER because I just knew in my heart that something was wrong, and none of my doctors would listen to me.  Ive been thinking I had a fistula for a while now, but everyone kept blowing me off saying that it wasnt.  So when I got to the ER and I spoke with the doctor the first thing I told her was to give me a CT scan with the contrast and that I wouldnt leave until it was done.  Suprise, suprise. The CT scan showed a small fistula going right into the hole in my stomach.  Then the ER doctor offered me a job, jokingly for my "well thought out diagnosis" I did on myself, I thought to myself "well thought out?"  It doesnt take a doctor to tell someone if they have crap (litterally) coming out of a hole in their stomach that its probably a fistula.  Anyways, they admitted me, and the next morning one of my surgeons partners came in and told me I would need surgery to fix it, so Im now waiting until my surgeon gets back into the US from a business trip to plan things out with him.

My daughter is still draining from her abcess and today she had to leave work the pain was so bad.  I thought with the drains an abcess is supposed to close up.  What kind of surgery do they do for abcesses?

Because her's is on her bottom, she can lie in a warm bath for some relief but as soon as she gets up the pain is back.  She taking percocet now but it's too binding and she has to change to vicadin and that still does not get rid of the pain.

I'm not sure about the fistula, she may have one.  I think it started draining into her anal canal and they put a drain in to assist in the drainage last July and cleaned out the abcess (supposedly) I'm not sure anymore.  After a few weeks they took the drain out and then put it back in in October because she had stopped draining and she could feel the pressure building up.  However, nothing happened she has been draining all this time then 2 weeks ago they went in and "irrigated the abcess" and put in 2 more drains.

So if the surgery is just cleaning out the abcess she has had that twice now and she's been on Cipro for a couple of months - not now though.  Her surgeon said the abcess goes almost from her tailbone to nearly her vagina.  The first surgeon was from our colo-rectal surgeons office but not the one treating her.  I'm hoping that since it was her treating dr. that did the surgery 2 weeks ago he will have a better understanding of the size, location etc. of hth abcess and somehow that will help her.

The pain she is experiencing with this abcess is intolerable.  Is that normal with most abcesses?

I would assume yes, however my abscess and fistula are both on my stomach right above my bellybutton so Im not putting hardly any pressure on it.  Before the abscess burst tho it was extemely painful, but now I dont feel it.  Sounds like a fistula to me, it could be a mix of both...but Im not a doctor I just know what I went through.  All I know is it continually drains, and I was now told not to pack it, just to cover it and tape it. I was like oh thats real cute, because theres nothing better then going to work and having to worry about it leaking and smelling.

Hello Geordie Lass! Welcome to the Forum! Sounds like you had quite the experience! Does the aquacell act like a plug?

Crohn's pt mom and MAG102886 -- I think we are talking about two types of fistulae, and the treatment is different for each. One exits from the abdomin. It appears surgery is often used to treat it, but some may heal with medication. I am not familiar with this type. I am too familiar with the second type which starts in the rectum and exits to the skin nearby (perineum, cheek, etc.). (Fistula can also go to the vagina, but I don't think anyone mentioned that type in this thread).

MAG102886 -- Good for you!! But I am concerned about your surgeons' performing surgery on you if they couldn't even recognise a fistula and wouldn't listen to you. Grrrrrr!! If it was so easy for the ER to see, what is wrong with your doctors? Is this the first time they have seen this?? Please, please make sure they describe in detail exactly what they are going to do. If they don't know Crohn's, they may not know which procedures are more successful. We just don't heal the same way. If you have any doubts, please please go see a colo-rectal surgeon who has experience in CD rather than a general surgoen who perfroms run-of-the-mill abdominal surgeries.

Crohn's pt mom -- I am concerned about her level of pain and that this has been going on for so long. Doesn't sound like the abscess/infection is gone. Does she have a fever? The second surgery was 2 weeks ago so she should be improving (slowly, but still moving in the right direction). Is she improving?? I had a pair very large and very deep abscess that went from vaginal wall to rectum. The surgeon opened it up wide and scaped it out. No drain was used because the surgeon opened the whole area up. I ended up with a whole the size of a small ice cream scoop, but it healed completely!! Took a couple of months but I really didn't have that horrible abscess pain and I felt better and better. Drains can be bad because bacteria can actually get back up there through the drain, and I am wondering if that is what is happening. Maybe she needs several days of IV antibiotics too. I would get a second opinion. It just doesn't sound right. I recommend a good colo-rectal suregon who knows CD at a teaching hospital.

Take care everyone!

Hi Mag,

I'm glad you like him. I think he should have explored the abscess cavity more for a fistula. They use dye and see if it comes out somewhere else. Also, testing the discharge from your wound would have told him if it was wound fluid or stomach/intestinal stuff. So was he just not being thorogh enough?? You probably have his full attention now after another doc confirmed the fistula. I hope he can get this fixed ASAP for you! As for declining the offer of the other doctor. Don't feel badly. YOu can't let aomeone cut into you unless you have checked them out. Maybe he is experienced, but maybe not. You weren't in critical condition and needing emergency surgery, so I think you were smart ot wait.

What I have learned -- and what you just proved in insisting on teh scan -- is that we have to be active in managing our own disease. If we think we know what is worng, the doctors need to listen to us. We just can take the risk of doing anything less!

Take care!

This is a really old post; it might be better to make a new thread so that more people see your question.