Is testing for infections a standard thing after surgery?

My 82-year-old uncle had colon surgery (hell, he had the whole damn thing removed!) almost two weeks ago. Last week, my cousin (his daughter) expressed concern that he didn’t seem to be getting his strength back very quickly, and thought there might be something else wrong with him. The doctor said he would run some more tests and let her know if anything showed up.

Good thing, too. It turned out he had a major abscess inside where they had reattached his small intestine. So my 82-year-old uncle had to undergo surgery again to have the abscess cleaned up.

Now the question: I would have thought for a serious surgery such as colon removal that they would keep an eye on white-cell counts in case of infection. Would there be an elevated white-cell count for an abscess? Or is that something that just might be at the discretion of the doctor?

It’s usually at the discretion of the doctor. But as a general principle, one should suspect an infection before looking for it. Therefore, patients are usually instructed to watch for signs of infection, like fever, chills, aches, swelling, drainage, pain, weakness, etc.

It usually doesn’t pay to screen all post-op patients for infection. For every infection you catch with an elevated white count, you’ll find 2 or 3 elevated white counts which aren’t related to a disease, yet still will need testing (sometimes invasive, which carries risks too) to make sure nothing’s wrong. And you’ll get normal white counts back on some people who will turn out to have infections.

It’s best to talk to and examine the patient, then order the test which will either tend to confirm or rule out your suspicions about them.