Q. Fluid is leaking from the incision made for hernia surgery. What to do?

Answered by
Dr. Bhavin Bhupendra Vasavada
and medically reviewed by Dr. K Shobana
This is a premium question & answer published on Dec 10, 2020 and last reviewed on: Jun 11, 2021

Hi doctor,

My sister underwent hernia surgery in her right lower abdomen four months back. As she was having slight pain and fever at that time, the doctor suspected some infection there. When the surgery was done, her infection was mild but they did not place a mesh there. Her surgery went fine. After a week or two, we saw a small hole in her incision. She started to have some fluid leaking from it. We consulted the doctor again. He asked us to monitor it for some months. It has been a month now. The incision has some fluid leaking from it but she does not have pain or fever or anything. She has some clear fluid that seems to be thick and odorless. We can see some progress and it has reduced a little bit. What is the reason for having it? She is completely fine. But she has some fluid coming out of her incision. We went to another doctor and he suggested having surgery saying that it can be an intestinal fistula. Kindly help us.

#

Hi,

Welcome to icliniq.com.

Your sister needs a personal examination. Generally, it should be healed by now. But sometimes it takes some time. Please mention the amount of fluid leaked out. If it is a small amount, then I suggest you wait for a month. If it does not heal, then do a CT (computed tomography) scan. Surgery can be decided based on her CT scan findings. But it looks like nothing serious. I suggest you wait for some time and then decide.

Thank you doctor,

The doctor has asked her to wait for six weeks again. She usually has a small to medium-sized patch on her gauge. She is eating a lot of junk foods but her bowel is completely fine. She does not have a fever. The liquid remains a little bit yellowish or sometimes transparent. But it does not look like pus as it is odorless and she does not have any pain in her incision. During her surgery, she was not placed with a mesh due to the cavity present in her. We suspect it as the same cavity or something in the abdominal wall. We are worried as it can be an intestinal fistula. We are just applying betadine daily.

#

Hi,

Welcome back to icliniq.com.

I agree with the suggestions of your doctor. Kindly wait for six weeks. Mostly it will get healed. Even if it is an intestinal fistula having some small amount of fluid coming from it, it will not cause any problems. So forget it and wait for some time. Washing it with hot water will be sufficient.

Thank you doctor,

We hope that she may not require surgery and it will get healed on its own. She does not take a bath for two months because once when she did it, she had a lot of liquid coming out from it. Can she clean the hole with a warm towel?

#

Hi,

Welcome back to icliniq.com.

Yes, she can bath normally.

Thank you doctor,

We can see the liquid turning thick and brown for the past two days. But she does not have any pain or uneasiness. Is it due to Betadine? Because the original color of the liquid remains yellow and sometimes, thick.

#

Hi,

Welcome back to icliniq.com.

Yes, it can occur due to it.

Thank you doctor,

It is almost a month after waiting for the liquid to subside. She has done her CT scan. The doctor told that there is a connection with her intestine. The amount of fluid coming from it has reduced. She has a single drop or even less and it is not thick. It seems to be yellow in a very small amount. We did a culture test and it shows nothing abnormal. There is an absence of bacteria. She is completely fine and her bowel is also fine. She does not have any fever, pain, or anything. When the doctor was doing a CT, some amount of dye went to a little near the intestine. He suggested that she needs surgery requiring removal of intestine. Again, he asked us to wait for two months saying that it can get filled up on its own sometimes. In some cases, surgery is required. What is your suggestion? Does it look like something related to the intestine? Kindly suggest.

#

Hi,

Welcome back to icliniq.com.

If your sister is not willing to do surgery, then she can wait for some time as everything gets decreased with time in some cases. Mostly it will heal on its own even if it has a connection with the bowel. She can have a conservative approach.

Thank you doctor,

I forgot to mention that the doctor told me that the size of the cavity remains around 1 mm to 1.5 mm. Does cutting off intestine is required to remove a small fistula? We do not know whether it penetrates the intestine or just touching it.

#

Hi,

Welcome back to icliniq.com.

It has higher chances to get healed on its own. If there are any symptoms present along with this little discharge, then your sister can go for surgery. Otherwise, it will not create any problems.

Thank you doctor,

I am attaching her CT reports. Kindly go through it and give your opinion.

#

Hi,

Welcome back to icliniq.com.

From her CT reports, (attachment removed to protect patient identity) it looks like a healing fistula. Wait for some time till it becomes healed. Do not be worried and do not be in a hurry to undergo surgery. Mostly, it can get healed on its own.

Thank you doctor,

Kindly go through her attached images and CT.

#

Hi,

Welcome back to icliniq.com.

Wait for some time. Mostly it will get healed on its own and it has healed almost already.

Thank you doctor,

I am attaching her previous CT reports. After doing surgery, my sister has some fluid coming out for a month. It got reduced with time. But now, it has started to come again in more amount. We are going back and forth. But it has got increased slightly from last week. Kindly tell us a solution. Can it be resolved without surgery?

#

Hi,

Welcome back to icliniq.com.

Yes, it has some connection with the intestine. It happens due to complications of intestinal surgery. Most of the time, it gets healed on its own. It can be problematic only if it drains with more than 500 ml daily. Surgery can be avoided while having fluid less than 500 ml. Sometimes, a bag can be used to drain it. A slight soaking of dressing can be seen in your case. It heals on its own by six months and sometimes, it takes a long time. But re-surgery causes more difficulty and more complications can occur due to it. So it is better to avoid it. Do not keep thinking about it on a daily basis and stop evaluating it. It will get healed soon and if it does not heal, your sister can have slight discharge and leave it as such. It will not hamper her life. In this current situation, it is good to wait for two to three months before taking any decision. By that time, it can get healed.

Thank you doctor,

She was getting only a few drops for the past two to three days. But from the last night, liquid remains thick and a half tablespoon of thick liquid came out today morning and again after two to three hours. Is there anything to be worried? I am attaching a picture.

#

Hi,

Welcome back to icliniq.com.

There is nothing to be worried and consistency can change off and on.

Thank you doctor,

Her discharge was pretty less for the past few days. Yesterday, her wound became closed from the top. But still, he has some fluid coming from inside and we can see a small bulge over the cavity. We pierced it with a sterile syringe and fluid came out. Yesterday night, she had more fluid than usual. I am attaching a picture. My sister told me that she feels to have some gas coming out of the wound once. Can we pierce it?

#

Hi,

Welcome back to icliniq.com.

Do not pierce on your own. Leave it to get healed. If your sister develops any swelling, then it is good to consult a local surgeon.


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