Need Recommended Gastro Doctor & Surgeon - Govt. Hosp.

[buzzer]

I have a friend who accidentally swallowed some glass almost 2 years ago. He developed peritonitis. He's rather stubborn, and it is hard to get him to see a doctor. So, the peritonitis had progressed a lot before he submitted to going to the doctor the first time. He had laparoscopic surgery done at Sirirad Hospital, but wasn't getting better. They noticed that the operation was done poorly, and gave him a free second surgery to fix the first surgery.

BTW. It's possible that the peritonitis, as such is no longer a problem, as he was treated with antibiotics for a long period of time.

I believe that that 2nd surgery was done improperly, as well. A few weeks ago, he started vomiting. After a few hours his vomiting turned black, and more violent. Large amounts of black and red bloody vomit poured out of him, then stopped. He was in the local hospital 5 days and got 2 250cc blood transfusions. His blood tests lately are below the low normal limits. There is no gastro doctor, or equipment at the local govt hospital. To have him cared for properly he would have to go to a larger hospital. Apparently, though they were willing to take responsibility for a bad 1st operation, they are not willing to take responsibility for the 2nd bad operation, of pay for it.

Due to monetary considerations, he is forced, to use the Govt. Hospitals, or some other (if they're inexpensive enough) Bumrungrad, BNH, and Samitivej are not on the list.

What the doctors suspect is that the 2nd operation left him with an abscess, somewhere in the stomach - probably between the inner and outer layers of the stomach. Slow internal bleeding is filling up this abscess, which eventually breaks - erupting into the stomach. So he needs a doctor that can find the source of the bleeding, and seal that off, as well as any remaining wound on the inside wall of the stomach.

He also doesn't eat. Many foods cause him pain, and he can't eat much without feeling full, which would suggest the abscess is filling the stomach, diminishing its capacity.

I have my own gastro - related problems, but I wouldn't even recommend him to my own gastro doctor. Besides, she would direct him to an expensive surgeon. I don't know if we can find this - inexpensive, but caring and good in Thailand, but I write this in hopes that someone out there has. We are in Samui, so the closest hospitals are Suratthani, Had Yai, and Phuket, but going to Bangkok, or anywhere to find the right 'team' would be OK.

Thanks - Buzzer

[FBN]

This is now a very complex problem and I doubt that the diagnosis at the moment is the correct one. An abscess within the stomach wall is unheard of.

He will need ultrasounds, gastroscopies and a full workup. Apart from this, the previous operations, assuming that he had a bowel perforation due to the glass with subsequent peritonitis, would have resulted in multiple intra-abdominal adhesions which may be causing bowel obstruction.

Any subsequent surgery would require a very skilled surgeon due to the adhesions as well as other hospital support; you are likely looking at some time in ICU as well if another operation (which seems likely and reasonably urgent) is needed.

None of the government hospitals in Surat or Phuket would be able to manage this. Perhaps the University Hopsital in Had Yai but, ideally, you should look at getting him to a place like Chula here in BKK.

[buzzer]

This is now a very complex problem and I doubt that the diagnosis at the moment is the correct one. An abscess within the stomach wall is unheard of.

He will need ultrasounds, gastroscopies and a full workup. Apart from this, the previous operations, assuming that he had a bowel perforation due to the glass with subsequent peritonitis, would have resulted in multiple intra-abdominal adhesions which may be causing bowel obstruction.

Any subsequent surgery would require a very skilled surgeon due to the adhesions as well as other hospital support; you are likely looking at some time in ICU as well if another operation (which seems likely and reasonably urgent) is needed.

None of the government hospitals in Surat or Phuket would be able to manage this. Perhaps the University Hopsital in Had Yai but, ideally, you should look at getting him to a place like Chula here in BKK.

Hi,

Thank you for your quick and courteous reply. You seem to be much more well informed than I. The diagnosis of an abscess growing in his stomach was formed from my own lack of knowledge, talking with a Thai nurse who spoke little English communicating what the non-specialist local doctor had to say, so you can see how such a diagnosis would be full or errors.

I thank you for mentioning Chula as I have never really considered them before, and their name has never come up in discussions with my friend. The thing now is to break through his stubbornness and (somewhat understandable) fear of doctors to get him up there.

Thanks - Buzzer