Burst appendix/peritonitis in 3 year old - urgent advise

[jaabaar]

Hi

My 3 year old dd just came home after surgery for perforated appendix.
I had no access to info on net in hospital.

Have read a bit now and I'm getting very upset.
All the treatments I read she should have had it was not followed. Also I was only told by the 3 rd doctor that the appendix had actually burst.

Is anyone on here who can give me advise?

Where shall I go with my questions? Gp? If I make emergency app they will only see me 2 min?

I'm very worried abt this and feel I was not informed. Please help me with some advise.

Thank you

Do you have a number for the ward she was on? Do you have immediate concerns about her or is it a case of needing to arrange follow up? I'd be on the phone to the hospital - tonight if it's urgent, tomorrow if not, and in the medium term I'd also put in a complaint to PALS about poor communication.
Hope she is better very soon.

No follow up was arranged.

I'm raising the question why she was sent from one hospital by ambulance blu light to great ormond street hospital arriving at 8 in the evening. Then nothing happened til 2 in the morning!

I asked them to put her at least on a drip and begged for painkiller. She was eventually operated on the next day at 16 hours. Her body was yellow from top to toe. When I asked doctors they told me: yeah isn't it funny?

I ask doc isn't there a danger that appendix will burst? He says oh no that will take 2 to 3 days

I'm so upset. Was there 6 days not slept. Now I'm home I only realise the seriousness.

I read that a blood test should be done before release to check if an infection is still being fought by the body.

Not one test was done although surgeon told me one should be done every day. When I reminded they said she is clinically ok so no need

How do I get medical records and does it state all the medicine that she received?

When I left only a nurse gave me the medicines.

I want to know if it was necessary to do a white blood cell count test before leaving hospital?

I want to know if antibiotics needed to be given before op?

I want to know if it is necessary to have a follow up post op?

I would have liked to know how serious peritonitis is?

This are a few of the questions...

Unfortunately I had no info abt appendix/peritonitis until I had access to web

Regarding pain relief:

She had Panadol after 5 hours at the hospital.....

Before surgery they gave her only Panadol! Of course after surgery she was on morphin and paracetamol. I believe they should have given something stronger from 8 in the evening until afternoon next day or if they clinically can't they should at least have explained!

The only advise I got is to take her to gp if fever is higher then 38.

I believe that I had the right to know how serious peritonitis is. Just my strong personal opinion.

Antibiotics: she was planned to be on iv antibiotics till Wednesday. Her iv needle came off Tuesday morning so they said they will not put her through pain of another iv needle and send us home early with 2 day worth of oral antibiotic.

The nurses have been absolutely amazing, loving, patient and caring with her.

I just feel that I should have been given more info

Peritonitis is inflammation of the lining of the abdomen caused by spilt blood, bowel contents or pus & it can be very serious but with a burst appendix once the appendix is removed & the bit of bowel next to it checked & closed the abdomen is washed out & usually the peritonitis is fully treated. It is standard to give antibiotics at the time of surgery but very debatable about giving them before. I believe the latest guidance is only to give if surgery is likely to be delayed greater than 24hrs. There's generally no point taking a blood count immediately after surgery as the inflammation caused by the surgery itself will cause it to be falsely high & it can take a few days before it starts falling. As for pain relief it completely depends how much pain your child appeared to be in & how much paracetamol helped.

Hope this helps.

Panadol didn't help and my dd was in great great pain, all she was able to talk to me for those hours were the words:
No mummy, no mummy, no mummy! Over and over sgain

If you give too much pain relief it can mask the severity, of the illness.

They took her to the most appropriate hospital.

Peritonitis is the same as any other illness. You can have it mildly or extensively. If the appendix had just split moments before, then the spoilage would be easily contained. The surrounding area would have been thoroughly washed out and IV antibiotics given during surgery.

If your DD is well in herself, that's a good indication that there isn't residual infection. If she becomes poorly in any way, you need to contact your gp.

Peritonitis is just a word that describes inflammation of the peritoneal cavity, it doesn't indicate severity in itself.

She would have been given the antibiotics before surgery IV by the anaesthetist in the anaesthetics literally moments before she went into theatre so they were in her blood stream when surgery was happening

What time in the day did you arrive at GOS and what time did she have the surgery, OP?

OP you're clearly very upset by this experience and that's absolutely understandable. I would caution though against too much googling.
If you contact PALS at GOSH they can liase with the surgical team and go through the notes with you so you can see the decisions that were made.
Recovering from a hospital stay is something that parents need to do as much as a child does. It can be very scary and when you're in the midst of it you don't have time to reflect on every aspect. Then when you get home it all catches up with you a bit. Try and focus on your little girl. She's been discharged well, if anything changes go straight to your GP, but she's ok.

Thank you all for the comments. They all make sense. I just need to catch up with sleep. Im happy they saved her.

The surgeon said that she could have died within 24 hours without operation as the infection was in her system.

They diagnosed appendix on a thursday around 2 in the afternoon. She was operated on friday at 4 in the afternoon.

Thank you all for the comments. They all make sense. I just need to catch up with sleep. Im happy they saved her.

The surgeon said that she could have died within 24 hours without operation as the infection was in her system.

They diagnosed appendix on a thursday around 2 in the afternoon. She was operated on friday at 4 in the afternoon.

Im at odds again. Receive letter with discharge summary. 80% of details are wrong. It states that she had appendix without complications (it perforated and she had peritonitis).

It states she was operated same day (she was operated next day)

It states her urine was ok (her nappy was red with blood)

It states she passes normal stool without blood (in fact she didnt have a bowel movement at all

It states they gave her oral antibiotics on 5th day (did not happen)

It states antibiotocs prescribed to take home (i didnt get them)

.....and so the list goes on. Im did not want to complain abt anything after i got a good nite sleep, but surely her medical records should be correct???

OMG Jaabaar, how much one parent can get? I am so sorry you are going through all of this.

Can you please check that this is the correct discharge summary for the right child. (I was discharged once with the details of the wrong patient).

Make a call into the ward to find what happened to the meds - maybe the discharge nurse did not pass them to you. It is shit, but it does happen (also speaking from person experience). If non are available, make an emergency appointment with the gp and discuss with them =ask them to prescribe.

May a call to PALS - patients liaison.

Be strong. Get sleep. It is a mess but you will sort it out and your family will be ok, the worst seems all behind now.

Hugs.

Bemuse be
Thank you for your kind words. I was not going to raise any comments with hospital as I over exaggerated in my previous posts as the final result is that she is fine and they actually saved her life!
So I calmed down.... And got this letter today.

Do you think it is reasonable to expect corrected details? I just want to make sure her history is as per facts. And leaving out peritonitis I thing is not insignificant. Right?

Ohhhh bemusebe got auto corrected above... Apologies...

I would certainly demand an explanation for what you thing are wrong entries.

It is important to get the full picture right.

You are right.. The main thing is that your DD is ok. But I think you need to speak to Hosp and find out what on earth is going on.. Having correct details is super important. If it were me I would contact them (I'd probably actually go to the ward) and ask them to clear up their mistakes.

Thank you LizzyP1

Just wanted to be sure that I'm not over the top.... And stating that appendix was perforated and peritonitis is quite a big thing to leave out.

Thank you.

My dd is finally fully back to her happy self!