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BRMIL
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kidney infection & cancer scare after bypass
Posted: 06-14-08 20:07pm
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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%u201D,. 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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Dr. Nikola
Doctor
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Posts: 912
Location: Strumica, Republic of Macedonia
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Posted: 06-16-08 03:07am
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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
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BRMIL
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Update after gastro doctors visit
Posted: 07-06-08 12:04pm
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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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Dr. Nikola
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Posts: 912
Location: Strumica, Republic of Macedonia
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Posted: 07-07-08 06:19am
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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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BRMIL
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Back in hospital
Posted: 07-12-08 21:46pm
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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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Dr. Nikola
Doctor
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Posts: 912
Location: Strumica, Republic of Macedonia
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Posted: 07-14-08 08:19am
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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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BRMIL
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Posted: 07-17-08 19:13pm
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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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Dr. Nikola
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Posts: 912
Location: Strumica, Republic of Macedonia
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Posted: 07-18-08 04:48am
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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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BRMIL
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Bone scan today
Posted: 07-23-08 08:20am
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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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Dr. Nikola
Doctor
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Posts: 912
Location: Strumica, Republic of Macedonia
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Posted: 07-24-08 08:19am
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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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BRMIL
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Posted: 07-30-08 20:09pm
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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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BRMIL
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Now on a heart monitor
Posted: 08-08-08 07:16am
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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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Dr. Nikola
Doctor
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Posts: 912
Location: Strumica, Republic of Macedonia
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Posted: 08-19-08 08:23am
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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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