Help! Don't know what is going on.

[Cindy40]

Hello everyone,

I am hopeing someone can give us a clue to what is going on with my father-in-law.  He went in for a routine colonoscopy, and has now been in the hospital for 4 days. He started swelling directly after test. He has severe pain (bad enough that they have him on morphine) and abdominal swelling.  Last night he said he thought he would smother to death.  

The Dr. says there were no complications, just that it is the air that is injected during the test, even though he admits that he did not go far into the intestine.   He says his body is not getting rid of the air like it should.  Blood work shows elevated white blood count.  They started him on anitbiotics.  I think the Dr. also may have said something about the air escaping out into his body cavity?  How can that happen without there being a tear somewhere.

His wife does not know what to do.  Do they have him moved to another hospital?  Is the Dr. right about the air?  Will it go away on its own?  We are very worried.  He is suffering so much.

Any information is appreciated.  Thanks

[margypops]

I am so sorry he is suffering and I hope he is more comfortable soon, put your question into the Doctor Forum for more answers,

[crystalfresh]

That is one of the possible problems that can happen from a colonoscopy if a tiny tear of the colon happened during a byopsy. I don't know if this is what happened but it could be what you are describing. Yes I hear very painful when the body fills up with gas. It can heal on its own or may need to be stitched. They hospital should know how to deal with that as it does happen time to time. If small enough I would guess it should be able to heal on it's own. But painful yes I have read. Usually the patient feels terrible pain during the procedure so if he could go home it sounds as if it was a smaller tiny tear if that's what it even is. I'm just guessing. Not a doctor. But they make you sign a paper understanding that this could happen before doing the procedure. It is fixable!!!!!!!!! While extremely unpleasant until it is closed or healed!!!!!!!!!!!!

If this I'm guessing they have him on antibotics and are just waiting it out to heal or repairing it.

[crystalfresh]

Painful during if there is a tear. Even if the tear has already healed on it's own the air in side him will take time to be absorbed by his body. Not painful if no tear during.

[CrisC]

I t sounds like the doctor who performed the colonoscopy needs to sit down and explain what may be causing this. It is obviously related to the colonoscopy. And why would his WBC be high unless there is an infection somewhere. Has he had a cat scan to r/o abscess? An abscess could possibly form from stool leaking out of the colon into the abdominal cavity.

[Cindy40]

That is what I thought they should do.  I think they have only did a X-ray.  The Dr. agrees it was caused by colonoscopy, but denies any tears.  He says it is the air that is pumped into the colon during the test, and it has escaped into the body cavity.  I can not understand how that would happen without a tear.  I fear the Dr. does not want to find a tear, because he has done something wrong.  I may be way over reacting.  I am trying not to jump to any conclusions because I know I do not know enough about it. I have had several relatives have the test and nothing like this has ever happened.

But I know complications can happen.  My mother had bleeding and some pain, but it was after she came home.  It resolved itself a few days later.

It just seems that 4 days is way too long to do nothing is try to eleviate the pain.

[CrisC]

Air doesn't just escape through the walls of the colon or we'd all have free air in our peritoneal cavity from normal gas. Your FIL needs a CT scan. Is it just air or is there stool too? If air normally escapes through the colon then they would be using CO2 for colonoscopies.
Is he still having fevers? And why wouldn't they just order a cat scan? Maybe a family member can suggest it. What does his nurse think?

[CrisC]

As a matter of fact, I'd be tempted to ask the nurse to request the CT scan. She has to receive the order from the doctor first. If the doctor who performed the colonoscopy is not on call tonight then the on-call doctor would be consulted. I think its worth looking into if he is still in so much pain and elevated WBC to boot.

[Cindy40]

Thanks for your suggestions.  I asked about the CT and they said to do the scan he would have to have a clean bowel, and he is way too sick to go through that.
They are doing an x-ray today.  Will post any changes.

Thanks again.

[CrisC]

That's wierd. I was a CT tech for 8 years and participate in abscess drain placements with CT guidance. A clean bowel doesn't have anything to do with seeing an abscess on CT.

Not sure what they are looking for with a plain xray.

[CrisC]

How's you're father-in-law doing?