I had surgery for bowel obstruction, but the biopsy was done only for the appendix. Is that enough?

Question

Hello doctor,

I had small bowel obstruction on the twenty-seventh of last month. They took out the appendix and attached fat tissue. They also found fluid in the stomach pelvis and cul-de-sac. I have lived with really bad constipation for some time tried everything to decrease it. I also have been very bloated in the stomach area for a while. A hard bloating eas there, so I even went to a cardiologist. After this recent surgery, the bloating, especially by the rib cage and hips, decreased a good deal. I could finally feel my ribs touch. I had adhesions also. My report for a gross exam was received on the twenty-seventh of last month and completed the next day. My report says the final report or diagnosis is under interpretation, and it says embedded images, but there is no image. Does that mean they are embedded in the wax or embedded data-wise? It says the final report has a microscopic exam taken place, or will there be a separate report, or is this it? I am taking Advil. I have attached the reports for your reference. Kindly give your opinion.

Answer 1

Hello,

Welcome to icliniq.com.

I understand your concern and will help you with it. I have assessed the attachments thoroughly (attachments removed to protect the patient's identity). The histopathology report mentions in the interpretation, "Appendicular mucosa with minimal focal acute inflammation." Acute inflammation (neutrophils) is a microscopic diagnosis. Hence, in my opinion, this is the final report. Unusually, the interpretation is mentioned without descriptive microscopy, but it is possible in this case, as it is just an incidental appendectomy. Incidental appendectomy is the removal of a clinically normal appendix during non-appendiceal surgery. This avoids future acute appendicitis, which has a lifetime risk of around seven percent in the general population. However, at the age you have mentioned, it is not common and generally affects the young. Also, I cannot find embedded images written under interpretation. It is just blank. Ultimately, what I believe is that this is the final report. The radiological examination shows the presence of bowel adhesions, small bowel strictures, and distension. The diagnosis suggests Crohn's disease, and that might well have been the reason for your resistant constipation. It is good that your symptoms have resolved to a great extent. I hope this helps you, and I wish you a smooth recovery. Take care.

Answer 2

Hi,

Welcome back to icliniq.com.

I have seen the attachments (attachments removed to protect the patient's identity). It now shows the table of embedded images. I think the table of interpretation and embedded images are separate tables. But both are left blank. This looks like an incomplete report, and you should ask them the question. I cannot speculate what might be the reason for this, but surely things seem missing. The reason for fluid collection might be inflammation resulting from a bowel obstruction. Inflammation causes fluid to leak from your blood capillaries. The fluid should have been sent for biochemical and pathological examination. A biopsy would have helped to strengthen and confirm the diagnosis. I hope this was helpful.