The abdomen is large and hard after open surgery.

The term "belly" generally refers to the abdomen. After open abdominal surgery, if the abdomen becomes enlarged and hard, it may be related to factors such as scar hyperplasia, urinary retention, abdominal wall incisional hernia, infectious mass, or paralytic intestinal obstruction. Patients are advised to follow medical instructions for symptomatic treatment. Specific analyses are as follows:

1. Scar Hyperplasia

After abdominal surgery, each layer of tissue needs to be sutured. During the healing process, tissue growth is required for wound repair. If abnormal tissue growth occurs and leads to localized scarring, a hard lump or induration may form in the abdominal area. If caused by scar tissue, surgical excision and repair may be necessary.

2. Urinary Retention

Anesthetic drugs used during surgery can affect the function of the bladder detrusor muscle, making urination difficult. This causes bladder distension, increased intra-abdominal pressure, and abdominal enlargement. As the anesthetic is metabolized and the patient resumes mobility, normal urination typically resumes and symptoms subside.

3. Abdominal Wall Incisional Hernia

This commonly occurs at vertical surgical incisions in the abdomen. Open surgery may cause nerve or tendon disruption, allowing abdominal organs or the omentum to protrude through the defect, forming a hernial sac-like mass within the abdominal wall, presenting as a hard abdominal lump. It is recommended that patients wear an abdominal binder postoperatively to promote wound healing. Surgical hernia repair may be required when necessary.

4. Infectious Mass

If fat liquefaction or infection occurs at the surgical site after open abdominal surgery and is encapsulated by surrounding healthy tissue, an infectious mass may form, presenting as a hard abdominal lump. This may also be accompanied by fever, redness, swelling, and pain at the incision site. Prompt antibiotic treatment under medical guidance is essential, such as cefazolin sodium for injection or amoxicillin capsules. In some cases, incision drainage may be required.

5. Paralytic Intestinal Obstruction

An enlarged and hardened abdomen after open abdominal surgery may result from impaired bowel function due to the operation. If intestinal motility has not recovered post-surgery, paralytic intestinal obstruction may occur, leading to abdominal distension. Besides bloating, symptoms may include nausea, vomiting, and cessation of flatus and defecation. Patients may need temporary fasting and should receive medication under a doctor's supervision, such as compound amino acid injection or vitamin B1 injection.

In addition, abdominal enlargement and hardness may also be associated with internal bleeding or fluid accumulation within the abdominal cavity. Patients experiencing abdominal enlargement and hardness after open abdominal surgery should seek timely medical evaluation to avoid delayed diagnosis and treatment.