Urgent question about complications from colon surgery!

[lenagreen]

My brother (36) was hospitalized five months ago with what seemed to be appendicitis.  They removed his appendix at the hospital, but four days after his release, he experienced another, more painful infection in his colon.  He was hospitalized again, and part of his colon was removed, because they found an abcess (abscess) and diverticulitis.  He was in the hospital for about two months, and when all the signs of infection were subsided, he was released.  He was at home for only three days, and then he felt a sharp pain again.  This time he was hospitalized and given massive dosis of antibiotics.  About three weeks ago, they decided to remove  his colon and a part of his lower intestine.  Since then, he has had many complications and the doctors do not seem to know how to deal with this.  First, he had some air in his lung, which was removed.  Then, he had a small pocket of blood, which was also removed.  Last week, they found that his gallblader was severely infected, so they have removed it, as well.  It just looks like he is always getting infections in different parts of his body, but nobody knows why.  They have tested everything under the sun (he has been in the hospital with problems now for about 5 months).  His kidney and liver seem to be normal.  They have discounted the possibility of Krohn's Disease or Colitis with many different biopsis.  Can it be something else, like an inmunodeficiency problem?  We are desperate, and he is fighting for his life.  He is in Madrid, Spain, at the moment.  I am dying to get him to the States to be under the care of a specialist, but I cannot transfer him yet, since he is still in Intensive Care.

Please could you let me know if there is any other possibility that I should about which I could inform his doctor?  Perhaps you happen to know if there are any reliable and well-known specialists in Madrid, Spain, I can perhaps talk to?  I am going to Madrid on Friday to see him, and I will be staying for a week, in order to talk to his doctor and act as his advocate.  Not only he is my brother, but he is also my best friend, and this is the most devastating thing that has ever happened to my family.

His doctor, although doesn't seem to know where the infections are coming from, thinks that it would be a bad idea to transfer him anywhere.  I asked him whether he had consulted with a specialist on this (he is not a specialist, but a general surgeon), and he says that he has not, because he feels competent to treat him, and that he is doing everything possible to help him.  I don't know what I can do at this point.  Please, any help that you can offer will be greatly appreciated.

Yours,

E. Green

[Kevin Pho, MD]

I am sorry to hear what is happening.  It is difficult to comment on the case without personally reviewing the files - but here are some thoughts.  

It is possible that an immunodeficiency problem can be present (i.e. HIV) or a condition like diabetes present that can impede healing.  If there continues to be perforations from the multiple surgeries, leaks from these can also lead to recurrent infections.

If an infectious disease specialist hasn't been consulted, that's something I would advise - since the infections are recurring without a known source.  Another opinion is also encouraged, however as you mentioned, would be difficult as he is so sick.  

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.
Medical Weblog:
kevinmd_b

[trish731]

A related discussion, complatcation following colon surgery was started.