What are the differential diagnoses, workup, and pain management strategies for a patient status post (s/p) transverse resection of the colon, now presenting with abdominal pain and fever?

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Last updated: March 28, 2025View editorial policy

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Differential Diagnosis for Post-Operative Pain and Fever after Transverse Resection of Colon

Single Most Likely Diagnosis

  • Surgical Site Infection (SSI): This is the most likely diagnosis due to the presence of pain and fever after a surgical procedure. SSIs are a common complication of colorectal surgery, and the transverse colon is a high-risk area due to its location and blood supply.

Other Likely Diagnoses

  • Intra-Abdominal Abscess: A collection of pus in the abdominal cavity can cause pain and fever, and is a possible complication of colon surgery.
  • Anastomotic Leak: A leak at the site of the surgical anastomosis can lead to infection, abscess, and peritonitis, causing pain and fever.
  • Ileus: A temporary paralysis of the intestinal muscles can cause abdominal pain, nausea, and fever, and is a common post-operative complication.
  • Pneumonia: Post-operative pneumonia is a common cause of fever and pain, especially in patients who have undergone abdominal surgery.

Do Not Miss Diagnoses

  • Bowel Obstruction: A mechanical obstruction of the intestine can cause severe pain, vomiting, and fever, and requires prompt surgical intervention to prevent bowel damage.
  • Sepsis: A life-threatening condition caused by an overwhelming infection, sepsis can present with pain, fever, and hemodynamic instability.
  • Hemorrhage: Post-operative bleeding can cause pain, fever, and hemodynamic instability, and requires prompt surgical intervention to control the bleeding.

Rare Diagnoses

  • Adhesive Disease: A rare condition caused by the formation of adhesions between the intestine and other abdominal organs, adhesive disease can cause bowel obstruction and pain.
  • Stump Appendicitis: Inflammation of the appendiceal stump can cause pain and fever, and is a rare complication of colon surgery.
  • Gastrointestinal Fistula: An abnormal connection between the intestine and another organ or the skin can cause pain, fever, and malabsorption, and is a rare complication of colon surgery.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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