Post op ruptured appendix

[DebD]

My daughter was operated on 7 days ago.  The doctor said that her appendix was seeping (not ruptured) all over her left ovary and tube.  He closed the midline incision (from umbilicus to pelvic bone) with staples but left the bottom third of the incision open.  He has asked me to push a sterile swab deep into her belly to help it drain today.  He asked me to do this 2 times per day. I do not feel comfortable doing this.   Is this common practice?   Also, is there such a thing as a seeping appendix?

[Jaybay]

I had a similar situatuation a few years ago.  The first few days, the wound was drained and re-dressed by physical therapists at the hospital.  Yep, the same people who help you rehab from things like ortho surgery.  These folks also deal with burn debridement as well.  After that, it was up to me to swab and drain for the next couple of weeks.  It's really not that bad, and certainly not uncommon when a wound needs to heal from the inside out.  With as much infection as appears to be present with a "weeping" appendix, I assume that is the reason for this wound needing to drain and heal with an opening.  If you feel you need assistance for a few days, ask the doctor for a referral to physical therapy until it heals up to the point that you feel comfortable dealing with it on your own.

[lizziecee]

Hi Deb,

When I was dx with Crohn's in 1970, after 9 months of severe diarrhea and weight loss, I eventually had pain around the appendix area and my physician thought it was a burst appendix. The pain was from the terminal ileum (next to the appendix) which was grossly inflamed.   I had a laparotomy from umbilicus to pelvic bone as colonoscopy was not done in England in those far off days, and the surgeon found 15 different areas with Crohn's. Biopsies confirmed the diagnosis.  With hindsight and some knowledge, wish I had the appendix taken out at that time, but hindsight is a wonderful thing, pity it doesn't come with foresight!

I was very ill, as I had lost so much weight I went down to 70 lbs (I was 24 yrs old) so was not a good candidate for such serious surgery. In fact, my parents who lived some 300 miles away, were advised to come to the hospital asap as I was only given a 50% chance of surving the op. I have a very strong will to live and obviously survived it.  I was immediately put on 60 mg of prednisone (a steroid) to counter the severe inflammation of burst ulcers and crypt abscesses in my small intestine. I don't recollect any problem with the scar healing, but I did have stitches, not staples. I seem to remember I had drains in for about a week and was fed intravenously.  I was hospitalised for some 6 weeks post op, until I started to put weight on.  The surgery has left an ugly scar, but guess was necessary in those days to do such surgery.

Regarding drains, when I had a lumpectomy, and then total axillary removal of my lymph nodes for breast cancer in 2003, I also had two drains after each surgery, and I was not allowed home until the drainage bottle had less than 30 ml. of blood/plasma.

The only person I know who has had an appendix removed is my b-in-law. He had a ruptured appendix and was in hospital for 10 days. He too had the incision closed with stitches. He certainly didn't have an open area when he came home. I lived with my sister and b-in-law then, so remember it vividly.

I would be quite alarmed if I had to do the procedure your daughter's doctor prescribes, as it seems as if there could be a serious risk of infection, when living in a non-sterile environment.

Perhaps surgical procedures are very different now, and also in the US compared to England.  I would certainly try and get another opinion. Perhaps your PCP/paediatrician can help, or taking her to the ER?

I don't know how old your daughter is, but if she gets a serious infection in her ovary or fallopian tube, this could well compromise her future fertility.

I hope all goes well for both of you.
Kind regards,

Liz.