What's going on there?
September 7, 2013 | 30,00 EUR | answered by Dr. med. Kathrin Hamann
Hello, today I was discharged from the hospital after having undergone surgery for my appendix 1 1/2 weeks ago, which resulted in the formation of an abscess with free fluid in the lower abdomen. This was seen on the MRI abdomen.
I wasn't told anything else, and the doctor said she could confidently send me home.
I'm glad to hear that my CRP levels have decreased from 300 to 80, and I am feeling better.
However, I was a bit confused when I read the doctor's report, which mentioned: "There is notable thickening of the small intestine wall with moderate contrast enhancement in the left mid abdomen, which was not present in previous examinations."
...for further diagnosis, we recommend considering a capsule endoscopy...
What does this mean? Is it concerning? What could it be? I am now feeling uncertain, as no one mentioned anything to me and I was told I could go home with confidence!
Good day,
I am happy to help you further. In your case, I would not assume anything concerning, even without knowing the exact findings. Due to the history of appendicitis, I do not suspect a malignant event. Rather, I suspect a peristaltic wave of the small intestine, which often moves sluggishly after appendicitis. This can cause thickening at this point due to the contraction of the intestinal wall muscles (peristalsis), similar to how one would tense their biceps. This can appear as wall thickening in contrast-enhanced images (usually CT scans).
I consider it harmless and want to reassure you.
An ultrasound follow-up can be done in 3-4 weeks, or if symptoms persist, a procedure called capsule endoscopy can be performed (swallowing an endoscopy capsule that travels through the intestine with food and records an endoscopic film, painless but unfortunately very costly).
Do you have any questions about this? I am happy to help you further.
Kind regards,
Dr. K. Hamann
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