uneventful apara. cholecystectomy with swollen sac

[capthayes242]

Successful surgery Thursday evening at 9.  Got back home Friday day evening 8,  Much pain with surgery.  Saturday evening went to ER for bloody/black swollen scrotum and shaft.  Labs, U/SS and CT w/ and w/o  came out negative for a bleeding site.  Dr. says to go home and rest for 10 days, not out of bed, and see how the post surgery gravity of abdominal blood and fluids are doing in the testicle areas.  Tonight, it has swollen another 30%.  Scrotum is 13+" circ. and penis shaft 3'" longer and 9 " circumference.  Currently larger than an apple and barely fits in one had, like an over sized softball.  To walk with less pain, I lift my genitals which realistically seem to be 3+ lbs.  Called Surgeon on-call tonight and he did not return the call.  I am severely dark red, and black in the scrotum.  Am I in danger? Do I wait until its 2 foot in circumference and the size of a grapefruit?  I am very anxious and want to know how much longer to wait till I demand.  I know this is a rare complication. I've HCV, HE, H.Cirrhosis,  Live transplant is out of question.  HCV way to far advanced to treat with interferon.  High to severe HE confusion, loss of basic words, and priming now for an 2-3 day delusional episode.  Yes I'm as objective as possible, but quite anxious.  Can you guide me before I loose any more parts?  No fever either.

[Christopher R Watters, MD]

I can understand your frustration. Yes, in the face of liver disease the absorption of blood in a hematoma can lead to encephalopathy. They are at least partially correct in that the hematoma should eventually absorb but the concern is the low platelet count and ongoing ooze. Was a CT obtained to assess the magnitude of the bleed/hematoma?

[capthayes242]

Thank you Dr., Walters

Just returned from a 24 hour turnaround trip to meet with the Surgeon in the ER.  He left early for Chicago and sent his 3green interns (no offense - still learning to put practicum and knowledge to use).  One dug a 1/4 into the belly button and removed some infection.  Same one wanted to aspirate my scrotum to let some of the air and pressure off.  Wasn't done.  The 3rd senior stated the "elephant balls were normal, eggplant color or not, and should just go away.  I am now back to abdominal pain, low platelets and low WBC.  They gave me Rx for 10 days Keflex and to return for regular follow-up office visit on the 9th of May.  Also, after a few hours each day, the Encephalopathy has caused great confusion, fallen asleep while sitting and waking up--talking to no one there and thinking I'm editing documents on a lap top in front of me.  I have notified friends and emergency caretakers to keep a daily check on me and not to believe me if I DO seem in a delirium.

What should I ask my gifted and touted surgeon on Tuesday?  A man of my past profession and 7 years college, I was mortified in the ER Monday night.

Again, thanks = as my concerns are, (I think),I  increasing. But I'm practicing relaxation techniques and staying still.

Capt Hayes

[Christopher R Watters, MD]

As I said, in the face of portal hypertension this needs to be closely monitored as it is not the typical little hematoma tracking inferiorly. Contact your surgeon today.

[capthayes242]

Thanks for your comments.  But I don't think this is a typical inconvenience.  My scrotal sac and shaft are now huge, inflamed, and egg plant purple.  But the color is paling out because the are it's covering is expanding.  I guess the Scrotal sac is approximately 16" in diameter and painful just to view, let alone touch.  Today, Monday, I started a low grade fever of 100.2 and it is vacillating between that and 99.  It looks the shape of a genetically altered eggplant.

I am , today as onset, seeping  a yellow, mucous blood out of my belly- button.  I wouldn't call it a bleeding indicator of internal bleeding.  I fashioned a scrotal halter to keep it elevated when up and out of danger (from sitting, etc.)

With this additional and no pain relief (of course it hurts)do I still wait to normal follow up May 8, 2013???

Thanks for your thoughts and your help.  Just hurting really bad and hesitant.

With thanks,


Capt. Hayes
Fishing Lore and Time Out Charters  

[Christopher R Watters, MD]

In the usual situation this is just an inconvenience. In the face of portal hypertension it needs to be closely monitored. If no communication from surgeon may need re-evaluation in ER.