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I had my diversion with permanent end ileostomy on Nov. 3.  This was in part due to a very large abscess around the jpouch which had a mushroom drain placed a few days before the unplanned diversion, but which had a crazy amount of poop coming out of it.  Hence, the diversion.   Removal of the pouch will come in 6-9 months, depending on healing and other issues.  Dx. is Crohn's.  Removal had already been planned prior to this abscess situation.

The last few days, the hole which was created for the drain in the abscess/fistula (now a seton) has seemed tender, and then started draining which seemed to me to be a lot of grayish-pinkish stuff.  The area where we could originally feel the abscess, just to the rt. of the anal area, is indurated (thick and hard, like a lump), and it's getting to be more tender.  

Any opinions out there as to whether I should be alarmed at this?  I'm hoping someone will have experienced something similar and can put my mind at ease as to how these abscesses/fistulas behave after diversion.   I'll be sending my surgeon a note about it, but kind of wanted to wait to see if it settled down and whether this is just an ebb and flow of these sorts of things.  

Thanks.

 

 

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Ordinarily, increasing tenderness and firmness would indicate an abscess needs draining. However, since yours is already draining I can think of only two possibilities. One is that there just is local inflammation going on. The other is that you have a second abscess that was not previously detected. I’d check in with your doc (or whoever is covering over the holiday). If you have a significant fever, you’ll have to go to the ER if your doc’s office is not answering.

Jan

Thanks Jan.  No fevers or other abscess symptoms like I had with my previous abscesses.  My jpouch puts out similar output from time-to-time, which I was told would be normal at this point. 

If the draininage comes from the seton hole that was made in November, could there be another abscess inside that same area?  Not sure I understand all this (as usual )

I will be in contact with my surgeon or her PA.

Thanks TE Marie.  I've been reading up on this issue, and one of the suggestions was to try to empty the pouch of its mucous on a daily basis.  Since my abscess/fistula communications with the pouch, the theory is there wouldn't be much left for the abscess to drain.  I tried it a couple times, and it seems to help - no more big "accidents" from the abscess or elsewhere.  Hope it holds true for long term, we will see.

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