Symptoms of Abscesses in Abdominal Cavity?

[AndreaS]

Hi All,

I'm so thankful that you are all here and so willing to share your stories and support one another.

My name is Andrea, and My Fiance, Elijah was diagnosed with Crohns in October. We've always known it was possible due to a strong family history.

I was wondering if anyone could share their experiences with abscesses in the abdominal area? Elijah is on Prednisone (Tapering from 40mg since October, he is now at 15mg a day) and on 6MP since 1 month ago. They are trying to taper the prednisone for 3 months while the 6MP builds up.

Every time he goes down on the prednisone, his symptoms change/get worse. Currently, his abdomen (in the area where his disease is- the terminal illium) has gotten really hard, distended, hot, and swollen. It's not the whole abdominal area, just where the illium is. It is causing a lot of pain and pressure in that area and at his hip. He's hardly sleeping and having a hard time moving about.

We know he's not having a blockage- he is using the bathroom regularly, passing gas, and his stomach is making noise. He's not nauseous or feverish.

We can't get in touch with our doctor today and were just trying to run through the possibilities.....and we got to wondering about absecesses in the abdominal cavity.

Anyone care to share what they feel like, what the symptoms are, etc?

We're going to try to get in to see his doctor ASAP because he's in so much pain that it is going to hinder his ability to work.

Thanks so much!

 

[DustyKat]

Hi Andrea and :welcome:

My son has Crohn's in the terminal ileum and also suffered with the complication of a psoas abscess.

His main symptom was extreme pain and difficulty walking. He had a noticeable right sided limp and when he laid on his back he was unable to straighten his right leg and lay it flat on the bed without causing severe pain.

Matt had no other symptoms either, bowel or otherwise. He was also on Prednisone and Imuran (a similar drug to 6MP) at the time. He had no temperature, just be aware that these drugs can mask symptoms.

Either way, he really does need to be seen ASAP and at least have bloods done to check his white cell count and CRP.
Both times my son presented to hospital with these symptoms, due to the severe pain, he was admitted as his WCC and CRP were extremely elevated.

Good luck to Elijah! Please let us know how he is getting on.

Dusty. xxx

 

[archie]

hi I had an inta-abdominal abscess last year my symptoms were (as far as I can remember!) I was really cold all of the time and feverish (night sweats), tight tender swollen tummy sore to touch with re bound pain, generally unwell I looked grey and really tired. one thing for me was everytime I went over a bump on the road I could feel pain in my tummy. My right hip bone was sore with occasional pain into my right thigh and leg. All in all I just was unwell. My symptoms were bad but I didn't go to the hospital then unfortunately I suffered a perforation and had extreme dizzyness and constant pain and basically everything else I've mentioned but a lot worse. If you suspect an abscess he needs a CT scan and hospital treatment, don't let it get worse like I did. Good luck

 

[Grumbletum]

My symptoms were almost identical to yours, Archie and the abscess was on my bladder. Andrea, I think the fact that the area is hot ( I had that too ) is a sign of possible infection. I hope you can get in to see the doctor soon, get some treatment to put both your minds at rest.

 

[Artificial]

Hi Andrea,

Not technically Crohns related but I ended up with an abscess after I had my appendix out and I felt really feverish and fluey and generally crap. From what I can remember (it was a couple of years ago) the pain would get quite bad but would come and go.

Hope that helps

Rachel x

 

[Crohn's Mom]

I ditto what everyone else says. I just want to add that prednisone can mask the symptoms of an abscess, even in the bloods. I would not take any chances myself and go to the ER for a CT scan and bloods just to be on the safe side.

Best of luck and please let us know how he is doing!
Welcome to the forum

 

[AndreaS]

Wow! That was a lot of responses very quickly! Thank you all so much!

We looked over everything you guys said and He has a little bit of all of the above- We are forcing our way into the Dr's office tomorrow!

We have an awesome specialist at UNC hospital- he has Crohns himself, and works only with IBD. I wish we had emergency contact information for him.

Thanks alot for the responses- We're new to this and his symptoms have been changing so rapidly that it's hard to know what's to be expected and what is worth going in for. I'm convinced that this is one to go in for. Again, we really appreciate it. Good luck to you all as well

 

[AndreaS]

Hi everyone, I thought I'd post an update since you all were kind enough to respond to my question.

We went into the ER first thing Monday morning and have been staying at the hospital since then. He did indeed have an abscess due to a perferation....and a fistula is forming. Apparently the infection had gotten pretty nasty. He's on IV antibiotics, steroids, fluids and they placed a jp drain. They want to wait until the infection clears up and then do surgery. Best case scenario is a resection, we were told. Worse case scenario is that he'll have alot more removed and have a permanet ostemy (sp? ) bag.

This all happened so quickly! He was just diagnosed in October!

Anyway, I'm sure we'll be exploring this forum and asking more questions. Just wanted to follow through with the thread I started and say thanks again. If it weren't for what you all shared above I may not have been able to talk him into going in.

 

[DustyKat]

Thanks for the update Andrea.

That is what happened with my son and his occurred only a couple of weeks after diagnosis. He actually had his first hospital admission exactly this time last year! He also had a drain inserted but they kept it in until he was operated 3 months later. The reason for this was to allow the inflammation to go from acute to chronic and therefore hopefully reduce the amount of bowel removed and reduce the need for a temporary stoma (ostomy). His outcome was a relatively conservative resection with no temporary stoma required. My daughter was undiagnosed when she had emergency and also had a ruptured bowel and abscess. Her resection was far larger than her brothers but she also did not end up with a stoma, temporary or permanent.

With Elijah it would essentially be same. If they have no choice but to operate when there is acute inflammation then they either have to take a greater amount of bowel or to limit that they do a temporary stoma to preserve bowel and reverse about 6 months later. The reasons for these two outcomes is simply because you can't join inflamed bowel ends together, they won't heal. They will never really know what is happening until actually visualise the area when they operate, hence the wide ranging scenarios. If his disease is essentially contained to his TI though I doubt a permanent, as opposed to temporary, stoma would be on the cards.

Have a browse through the surgery forum and you will find loads of information and experiences similar to what Elijah is going through...

http://www.crohnsforum.com/forumdisplay.php?f=71

Good luck and keep us posted!

Dusty. xxx

 

[archie]

Hi Andrea that is exactly what happened to me, I was treated with 1 week of IV antibiotics then 3 weeks of oral antibiotics although they didn't start me on steroids until the infection had gone. I had a repeat CT a month later which still showed a collection of fluid. The surgeons always said I'd need surgery to remove the damaged part which I had 6 months later when I felt good. I had a straight forward ileocecal resection and have been good since. Try not to worry your in good hands and hopefully he will get better very soon. If you need any more info about surgery / treatment etc just ask as his case is so similar to mine.

 

[Grumbletum]

Hi Andrea
Thank goodness you managed to get him to go in and I hope it turns out to be the best case scenario and that he's on the mend soon. All the very best to you both x

 

[AndreaS]

Thanks again for the support everyone!

They sent us home last night As his infection level has stayed on a downward trend. The jp drain will stay in place until surgery. We've got antibiotics and pain meds and instructions for doing saline flushes 3 times a day.

We are meeting with the surgeon Wednesday to discuss our next step.

I'm trying to relax and not mother Elijah too much, he is very stubborn! We left with instructions for him to not lift more than ten pounds. Of course, we get home and he takes out the trash and recycling and he jostled the point at which the jp drain tube goes into his abdomen and now it's leaking slightly! He also told me he fully intends on going to work Monday (he does landscaping and construction work) ugh!!!

For those of you who have been through this....how difficult was it to learn to accept and adjust to temporary limitations like this? I want to be supportive to him in any way I can, but I'm obviously worried that he's going to push himself too much and further complicate the situation.