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Surgery...when to say when?

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Posted 4/4/2011 11:57 PM (GMT 0)
I have an intra-abdominal abscess about the size of a golf ball right next to my belly button that's at the end of a pretty big fistula (like 1in big) from my terminal ileum. I also have another fistula that attaches to my bladder.

Started Remicade which worked amazingly. First day in my abscess went down and in 6 weeks my fistula halved in size. Sadly, over the weekend (of course over the weekend) horrible pain again and that abscess popped back up.

Other then this, my guts are great and I had my life back thanks to Remicade.

I just got off the phone with my GI and he wants me to see a surgeon to have it drained... cry

Has anybody had an intra-abdominal abscess drained? Can anyone tell me what they went through?

Little nervous thinking about surgery like this...I'm debating about just jumping for a resection, because I'm worried this stupid thing will keep coming back..
Posted 4/5/2011 12:38 AM (GMT 0)
I would highly recommend you get a drain installed, and see how effective that is before cosidering surgery.

The drain usually stays in for about 7-10 days, and is flushed daily. From that point, the Remicade and Flagyl should take care of the rest. It was very successful for my daughter when she went through this.  

Tom.

Posted 4/5/2011 8:55 PM (GMT 0)
Tom - Thanks for responding. I have my fingers crossed. If you don't mind me asking, how long did it take for your daughter to recover from the placement? Hope she keeps doing well!!
Posted 4/6/2011 1:08 AM (GMT 0)
It was about 2 years ago, and as I recall, she spent 10 days in the Hospital with the drain in. After coming home, she was still on Flagyl and Prednisone. She was fully recovered from that in a couple of months, and was put on Imuran as she weaned off of the PRednisone.

You may have been on antibiotics for the abscess, but as it was explained to me, the antibiotic can't penetrate the outer abscess to work on the infection, hence the drain. 

Flagyl does come with side effects for most though, particularly feeling tired and dizzy. Like all meds these vary from one individual to another. 

She's been pretty well since, until recently when she started having pain again. It might be a fistula, so she's been put on Flagyl again while awaiting more tests. And on we go. Good luck with things, please keep updating.

Tom.

Posted 4/6/2011 11:40 PM (GMT 0)
Tooth -

I have had an abdominal fistula for a year and a half, but mine was in reverse order. I had an internal abscess the size of a grapefruit which was drained surgically. They left it open to heal, and I developed the fistula. I had it cleaned out about 8 months later, but no luck, the fistula hasn't healed.
Medications I have been on to heal the fistula include Humira (which does work for some people), Flagyl, & Cipro. I was also told to take probiotics and even imjected myself with Octreotide post surgically. Not sure what the last one was for, but it was supposed to help me heal and avoid infection (the abscess returning).

Both of the surgeries were close to the top of the skin. She did the absolute minimal amount of digging. The post surgical pain was easy compared to most surgeries I have had, and if were not such a complicated case, I'm sure my fistula would have healed by now ! lol

But anyway, as long as they don't have to mess with your bowel, the recovery should be fairly easy. In my case they just waited for me to prove my bowels were still working and that my husband was capable of changing the dressing (bless his heart!).

Good luck and try not to worry...

Sudsmom
Posted 4/6/2011 11:52 PM (GMT 0)
Thanks for the reply Sudsmom. It's glad to hear that your recovery was so good! Sad to hear that you still have that pain in the butt fistula. :( Hope your next surgery goes well! And I appreciate the advice!

I have a feeling I'm going to be more complicated as my fistula attaches to my TI. I'm starting to get cold feet about the resection, but if it makes the darn thing go away...
Posted 4/7/2011 9:09 PM (GMT 0)
Well I just had all the tests at Johns Hopkins on Tuesday (colonoscopy, MRI with contrast and slow mo, blood draw and EKG). I sure hope they found out where my fistula is! But knowing my luck, they will filet my gut like a fish (hmmm not sure that was the best analogy) just so they can see what they are doing. I've got my fingers crossed that for once I won't be one for the record books!

Good karma to both of us!!

Sudsmom
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