The Radiologist spent a long time today trying to find and trace any additional sinuses that lead off the main track. He also traced the main sinus all the way to its conclusion. This was all done with rather scarily long lengths of wire that I suspect were actually designed for running up arteries and veins. And the result was rather revolutionary.
It turns out that I actually have two leaks from my bowel, and that they are joined together by a single long sinus. The known leak is at the join between the J-pouch and the rectal stump. The newly discovered leak is at the blind end of the J-pouch, where it was closed off by the surgeon in the original operation. The Radiologist was able to pass a wire from the bowel into one end of the sinus, up the full length, and back into the bowel again at the other end.
Unfortunately it doesn’t look like that sinus runs anywhere near my left ureter though, which means my problems with my left kidney are still somewhat unexplained by this. So, the current suspicion is that there may be a “detached” pocket of infection that used to be joined to the main sinus, further up in the pelvis, not directly attached to anything any more.
The plan for tomorrow is to run me through a detailed MRI scan to validate the current findings, and search further for any pockets of infection closer to the ureter. The Radiologist will then reinsert the wire in a loop through the sinus, giving the surgeon a clear marker to work with. They’ll then hunt for some space in the operating theatre schedules to get me back in.
The hope then is that they may be able to open up that sinus sufficiently for them to fully drain it of any infection, and potentially to bring the Endosponges into play. In addition, there is a hope that if they can find any extra pockets of infection, they will also be able to gain access to them too, by way of the “new” end of the sinus, allowing them to drain them too.
However, there are still many problems to overcome. With the amount of very fine surgery involved, it would be all too easy to destroy the join in the process of trying to fix it. Even if we get all the infection drained out, there is no guarantee that I will actually heal well enough to withstand the reversal of my ileostomy. And, even if I stand the reversal of the ileostomy, there is now significant concern that due to the amount of scarring in my bowel, I may not regain adequate bowel function anyway. Which is all a bit negative.
But on the upside, I have nothing to lose, everything to gain, and I normally heal well. My surgeon still feels it’s well worth the effort to try to save the join, and I refuse to end on a low note!