- Pyrexia is a common problem seen after surgery
- Underlying cause may be identified clinically depending on:
- Time since operation
- Type of surgery undertaken
- Associated clinical features
Time since operation
- Specific complications often occur at certain times after operation
- The following time scales should be regarded as a guide and not absolute rules
- First 24 hours
- Systemic response trauma
- Pre-existing infection
- 24 to 72 hours
- Pulmonary atelectasis
- Chest infection
- 3 to 7 days
- Chest infection
- Wound infection
- Intraperitoneal sepsis
- Urinary tract infection
- Anastomotic leak
- 7 to 10 days
- Deep venous thrombosis
- Pulmonary embolus
Assessment of patient
- Adequate assessment requires a full clinical examination
- Respiratory complications often associated with breathlessness, cough and chest pain
- Wound infections may show erythema, purulent discharge or dehiscence
- Abdominal pain, distension and ileus may suggest a collection
- Calf pain and tenderness may suggest a DVT
- Appropriate clinical signs may be present
Investigation
- Useful investigations may include:
- Chest x-ray
- ECG
- Arterial blood gases
- Ventilation / perfusion scan
- Abdominal ultrasound or CT scan
Bibliography
Lanhardt R, Negishi C, Sessler D I. Perioperative fever. Acta Anaesthesiol Scand
1997; 111 (Suppl): 325-328. |