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CT Scans???

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Crohn's Disease
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Posted 9/9/2007 2:29 AM (GMT 0)
My wife has been having fever and abdominal pain(on and off all over the abdomen) for the last week. The GI ordered an abdominal CT scan for this morning. Well, the hospital called us tonight and asked us to go tomorrow morning because the radiologist wants a better look by doing a CT scan of the pelvis.  Does this mean he saw something in the abdominal CT Scan?
Posted 9/9/2007 2:38 AM (GMT 0)
It may mor may not, they may want to do a CT enterography which is a newer test and has more definition. In one of my 17 CT scans in 2007 alone...yeah I can chug that stuff now lol the one I had on my birthday...good ol friday the 13th they were unsure if there was a fistula from my intestines feeding the abscess I had. Do to it not going away I had another done May 4th this showed the abscess was gone...in fact I was still draining anywhere from 10cc-50cc of purulent discharge everyday. Eventually I had Sx to reverse my ostomy and remove the abscess, the DR said the abscess was about half the size of his pinky finger but I had gotten peritonitis from it.

One CT I had in Oct was to rule out appendicitis since I went to a walk in since my GI didnt believe that it was my CD. It did prove it was my CD but it showed kidney stones, no other evidence has shown kidney stones (including all the other CT scans I have had since). To answer you they may see something that is of interest that could actually be non existant or something that warrants more attention.
Posted 9/9/2007 3:05 AM (GMT 0)
The gi should have ordered the pelvic scan with the abdominal anyway......

Maybe he "thinks" something is there, and wants to confirm his suspisions, but
I wouldn't worry about it until there is something to worry about.....I know easier said then done, but try to get a good night's sleep, and then you can face what tomorrow brings you.
Posted 9/9/2007 5:10 PM (GMT 0)
The results came in from this morning's CT Scan of both Abdomen and Pelvis... They told us they found Active Crohn's.... They gave us the option of going thru the ER to get admitted or to get an appointment with our GI tomorrow morning. We chose B. We're a little bummed because we thought her Remicade was working... She was having reactions at the 7th week so they increased it to every 6 weeks... She had a great six weeks, they had remicade and a week after, she started feeling bad... Does this mean that the Remicade stopped working?

 

Posted 9/9/2007 11:13 PM (GMT 0)
It kind of sounds like maybe it has......is she on anything else along with it? Where was the active crohns at?
Posted 9/10/2007 1:38 AM (GMT 0)
She's on 100mg of Imuran. They did not mention where the active crohn's was... i guess the GI will tell us tomorrow morning.
Posted 9/10/2007 12:55 PM (GMT 0)
Hi How did the app. go? Somtimes the GI will adjust the doseage,I am interested in how your wife makes out .Keep in touch best wishes to you both. lol gail
Posted 9/10/2007 1:03 PM (GMT 0)
Has her gi ever ordered the prometheus propredict metabilites blood test? This tells if she is in her theraputic range for the imuran. He can always up her doasge of remicade and try that also.

Let us know how her apt. goes!
Posted 9/10/2007 4:15 PM (GMT 0)
They found mild inflammation in the small bowel in the upper left and lower left quadrants. They also found a 3.3cm abscess around her temp ileostomy. She's been on cipro for 3 days and the GI just put her on another Antibiotic called Alina (I think). He wants her on a liquid diet until he sees her on Friday. I take it Remicade is over for my wife. What are the next steps in this scenario?

 

Posted 9/11/2007 1:42 AM (GMT 0)
Hi Not sure what will be going on next for her but I am glad they found the abcess and she is getting treatment for it .I had one and I did not like it too much but that was before the Rem. At least her inflamation was mild perhaps the Rem. was working. Most people go onto Humira after Rem. The liquid diet will probably help . Hope she feels better soon. She is lucky to have you there for help and to look after her. Best Wishes.lol gail
Posted 9/11/2007 2:27 AM (GMT 0)
Thanks for your kind words. I'll keep you posted on her appointment on Wed.
Posted 9/11/2007 2:33 AM (GMT 0)
Just wanted to say that I hope your wife gets feeling better soon. Prayers sent her way.
Heather
Posted 9/11/2007 7:30 AM (GMT 0)
crohnshubby, dont be discouraged about the meds not working. you cant prove a negative result.. i used to be the same way. it just kept coming back worse and worse.. i blamed the meds not working and one of my older drs told me... we dont know that its not working, maybe it is and if you had not been taking it all it would have come back worse and sooner!
Posted 9/11/2007 1:17 PM (GMT 0)
Good way to look at it Randy... After you said that, my wife told me that the doctor even mentioned that once they get the infection controlled, he wants to give her double dosage of Remicade. I guess it's could be that she just needs more of it.
Posted 9/12/2007 2:01 PM (GMT 0)
CT Scan reads:

Apparent phlegmon measuring approx 3.3cm in diameter with small air bubble present which may represent early abscess or changes in association with microperforation. There is surrounding fat noted. A fistula may be present as well though not definitely defined. Mild thickened loops of small bowel were found in the upper left quadrant. Matted loops were found in the lower right quadrant.

Impression:

Phlegmon and possible early abscess within right lower quadrant inferior to level of ileostomy.

The GI has put her on daily 1000mg of cipro(Antibiotic) and 1000mg of Alinia(Antibiotic).

Could this be handled without surgery?  

Posted 9/13/2007 12:30 AM (GMT 0)
i doubt it. the phlegmon will grow untill it take up too much space. it is basically a growth of meat and fat that try to wall off the infection of a abcess or fistula. it will stick to everything in there and do more damage. the surrounding fat may be the beginnings of 'fat wrapping" which the body also does to protect itself. matted loops are not good. it just opens you up for fistula between the loops and for adhesion problems... my second surgery was for just the picture you describe. when they get in there things have to come out in big hunks cause its alll stuck together. if you would like to see a picture of a 'phlegmon' go to my website and click on CD photos. on one of the pages is some surgery pictures with a lump of stuff on a table. looks like a roast! thats one.
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