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kidney infection & cancer scare after bypass

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Here's the man! 50 yr old in great health until he had triple- by-pass 9 wks ago. Very little pain now because of that surgery. He's staying on heart-healthy diet, walking, etc. For the past two or three weeks, he has been suffering from abdominal pain.

Doctors ran CT scan week before last which showed among other things, "a 6.6 X 4.7 mass in the caudate lobe of the pancreas with smaller ill-defined low-density lesion" Dr. wrote "is worrisome for malignancy”,. Also said 3 tumors on his liver. Another CT Scan and MRI showed nothing on his pancreas but did show the tumors on his liver and the doctors said "they are not the type that are cancerous". Where did the lesions go or are the doctors missing something? This is very scary to us.

NOW, he has a kidney infection. His cardio doctor suggested that he go to a General Practice doc and that doctor has had him on an antibiotic and Tylenol for 2 days now & his fever is still at 101. We have no idea where to turn, what to do. He is in so much pain and has no energy. Please give us some ideas
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replied June 16th, 2008
Doctor
This man is probably no longer in good health.

By-pass surgery can improve heart condition but he should be aware of all the risks factors that can contribute to his heart condition: smoking, high blood pressure, high cholesterol, diabetes, overweight, stress etc.

Lesions like pancreatic or liver tumor(s) can not disappear that simply. He might try an ultrasound scan and/or a needle aspiration biopsy to get a precise diagnosis. You can consult some gastro-entero-hepatologist about this.

Kidney infections (pyelonephritis) should be treated in a hospital. Urine analyses can help to identify the infective agent the proper antibiotic to use. You can consult a nephrologist about a kidney condition.
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Users who thank Dr. Nikola for this post: BRMIL 

replied July 6th, 2008
Update after gastro doctors visit
Thank You for your suggestion of seeing the gastro doctor. She said the reports were totally incorrect about the pancreas as there is no such thing as a "caudate lobe of the pancreas" that tthe caudate lobe is part of the liver. We have scheduled an endoscope on July 23 as she wants to see what the doctor meant by a "fullness". We are in a holding pattern until then. His fever is gone and his energy level is way up. I'll make another posting when we get the results of the endoscope. THANKS.
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replied July 7th, 2008
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You are welcome. I hope that endoscopy will clear the case and find out what is really wrong with the man.
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replied July 12th, 2008
Back in hospital
He was admitted on Tuesday with fever 102. They did the endoscope and it showed no problems to the stomach any other organ they could see. His white blood levels are elevated, which we would suspect with an infection. His stool is very dark, but they find no internal bleeding with the tests they have done. They even tested him for TB. I think they are totally lost as to what is causing the fever. He still has BAD pain in his stomach area just below the sternum. I'll keep you posted. Ideas and recommendations are appreciated.
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replied July 14th, 2008
Doctor
What kind of endoscopy the did?
You can't examine the pancreas and liver with gastroscopy. Gastroscopy is used only for examining the esophagus, stomach and duodenum. Liver and pancreas can be examined with ultrasound, CT/MRI and laparoscopy. Laparoscopy is also an endoscopic procedure but the endoscope is inserted into the abdominal cage trough a whole on the abdominal wall.
What did doctors say about the "tumors" in the liver?
What about the kidney infection? Did doctors cure it?
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replied July 17th, 2008
They were looking for infection in stomach. The doctors admit they are all stumped. Stomach, esophagus were all good. The written report on the liver says
"Images of the upper abdomen demonstrate a large low-density soft tissue mass in the caudate lobe of the live measuring 6.6 x 4.7 cm transaxially x 6.6 cm craniocaudally. There is compression of the IVC, approximately 85%. Also seen is a 7 to 8 mm defined low-density lesion in the medial segment of the left hepatic lobe. In the dome of the liver, there is a more well-defined cystic lesion measuring 11mm. No significant adenopathy is appreciated in the visualized upper abdomen. There is fullness in the pancreatic tail with no discrete mass appreciated. The Osseous structures are unremarkable. There are post-surgical changes of a recent CABG."

As of today, he is 4 days without fever. THIS is the first time he's been off of an antibotic and not had fever within 3 days. His heart rate is ranging from 80 - 120 sitting position. They are having a hard time regulating it with medicine.

He is due to have another test next week. Will keep you posted. Thank you for your help!
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replied July 18th, 2008
Doctor
The real nature of those lesions in the liver can be diagnosed with percutaneous fine needle aspiration biopsy done under ultrasound monitoring.
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replied July 23rd, 2008
Bone scan today
They do not seem worried about the lesions on the liver. WHY? Don't know. My daughter said the dr. said these are not the type that are cancerous. The word she used sounded like hemeoingina. I know that is probably not spelled correctly. They are doing a full bone scan today and some more blood work. Happy to report that he still does not have fever. THIS is a record!
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replied July 24th, 2008
Doctor
If those liver lesions are hemangioma then you shouldn't worry, too, because it is a kind of benign tumor.
Why did doctors do bone scan? What was the result?
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replied July 30th, 2008
The did the bone scan just to see if they could find any reason that he is still running fever, I think. His fever is still 99 - 101, but the days are gone with the 103. Thanks for the note about the hemangioma. That is what they said, but at this point, we are looking for other opinions. THANK YOU>
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replied August 8th, 2008
Now on a heart monitor
He went for a check up at the cardiologist yesterday. He's still running 99 or so fever every few days. Doctor did not like his heart rate and put him on a monitor for 24 hours. More to follow. If we have to go back to surgery, we will all go crazy but do want him fixed. Thanks for your support.
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replied August 19th, 2008
Doctor
Heart inflammation like bacterial endocarditis can cause prolonged fiver. You can request microbiological examination of the blood and ECHO-cardiography co confirm or exclude endocarditis.
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replied September 17th, 2008
Kidney infection after heart surgery
Hope that man will be fine through endoscopy. Might be that person is having cholesterol, diabetes, overweight. Diabetes will break that person to the core if he is suffering through it. Tell that person not to take tension. Tension will be a main cause for everything.
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