Pain after appendectomy

I recently had a non-laparoscopic appendectomy (not ruptured), in which the surgeon also found some inflammation of the colon about 2" above the appendix.  This was also consistent with the pre-op pain being a bit higher than is traditional.  He could not identify the inflammed or abscessed portion of the colon  -- possibly diverticulitis, possibly a tumor -- neither of which seems especially likely, as I had a colonoscopy 18 months ago that came out completely free of diverticula, polyps or inflammation on the transverse or ascending colon.  Rather than cut the colon, he inserted a drainage tube from the inflammed area to about 6" below, which he removed gradually in the 2 days after the surgery.  The drainage was modest, mostly reddish clear.  He also put me on cipro and flagyl for the next 10 days, which I have just finished.  I still have some modest pain around the incision, but I am concerned about the persistent, dull pain near the edge of my ribs, above the appendix at around the area where he would have found the abscess.  I do not have a fever, and blood and urine tests 5 days ago were normal.  Ultrasounds have revealed that I have one gallstone (6mm) in an apparently normal gallbladder, and a small (3mm) kidneystone, but I have never had the classic symptoms of either.  Could my lingering pain just be from the disturbances of the surgery and the drainage tube, or is that unlikely?  It does  not bother me much when I lie down, e.g., I can press into my abdomen without much sensitivity, but it is more pronounced when I stand, cough, or breathe very deeply.  How long does post-operating pain around the affected area typically last?  Should I take ibuprofen or something similar to reduce inflammation?  Should I extend or modify the course of antibiotics?  Thanks for your help, or similar experience.

[Kevin Pho, MD]

The duration of post-op pain is variable, dependent on the patient and the procedure.  It can last from a few days to a few weeks.  

I cannot make any recommendation as to pain medication and antibiotics without examination nor reviewing your chart.  

The ultrasound is a good test to evaluate the liver and the gallbladder.  Repeating the CT scan can be considered to ensure there isn't any continuing inflammation or abscess.

These options should be discussed with your surgeon.

Followup with your personal physician is essential.

This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.

Kevin, M.D.
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