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Recurrent Abdominal Pain In Upper Right Quadrant, Done Hemogram, Abdominal Ultrasound Normal. Suggestions?
Question: i am 37 year old married women having one kid,for past 1 mnth i m having recurrent pain abdomen in right upper quadrant ,,for 2 days i m having sever pain continuosly...my hemogram shows ESR 92 AND PCV 19%,,COULD U PLZ SUGGEST SOMETHING...USG ABDOMEN IS NORMAL
Hi and thanks for the query
RUQ pain in a 37 year old female can be because of -
1) Acute cholecystitis - The pain pattern is as you have described and the ultrasound usually shows a thich walled Gall bladder with stones and some edema / fluid around. Rareli in recurrent cases all you could have is a collapsed gallbladder with stones within it called the "wall-echo sign"
2) Liver abscess- usually has a continious dull aching pain and may be associated with fever. Should be seen on an USG
3) Biliary motility disorder - continious pain is unusual and diagnosis is made by finding a dilated biliary system with altered liver functions during the pain episodes.
4) Duodenal ulcer disease - Episodic pains are usual and a persistent pain may be associated with complications like penetration. Ultrasound is usually normal and is usually diagnosed on an endoscopy
5) Rarely a renal pathology like obstructive stone - easily diagnosed on an ultrasound and urine examination
Repeating an ultrasound may be the first step followed by other tests if required
Regards
Dr XXXXXXX
RUQ pain in a 37 year old female can be because of -
1) Acute cholecystitis - The pain pattern is as you have described and the ultrasound usually shows a thich walled Gall bladder with stones and some edema / fluid around. Rareli in recurrent cases all you could have is a collapsed gallbladder with stones within it called the "wall-echo sign"
2) Liver abscess- usually has a continious dull aching pain and may be associated with fever. Should be seen on an USG
3) Biliary motility disorder - continious pain is unusual and diagnosis is made by finding a dilated biliary system with altered liver functions during the pain episodes.
4) Duodenal ulcer disease - Episodic pains are usual and a persistent pain may be associated with complications like penetration. Ultrasound is usually normal and is usually diagnosed on an endoscopy
5) Rarely a renal pathology like obstructive stone - easily diagnosed on an ultrasound and urine examination
Repeating an ultrasound may be the first step followed by other tests if required
Regards
Dr XXXXXXX
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
my MCV is also increased and it is 120,,skin of palm has turned black...s.total bilirubin is 1.51.direct is 0.3 and indirect is 1.21...
Hi and thanks for the information
The elevated MCV with a low PCV and an increased indirect fraction of the bilirubin indicates a possibility of Megaloblastic anemia with low grade hemolysis ie is destruction of red blood cells. This hemolysis can lead to an increase in bilirubin and in some cases pigment gall stones. Megaloblastic anemia is frequently due to Vit B12 or folic acid defeciency.
hence get a repeat uSg abdomen and serum Vit B12 and RBC folic acid done
Regards
Dr XXXXXXX
The elevated MCV with a low PCV and an increased indirect fraction of the bilirubin indicates a possibility of Megaloblastic anemia with low grade hemolysis ie is destruction of red blood cells. This hemolysis can lead to an increase in bilirubin and in some cases pigment gall stones. Megaloblastic anemia is frequently due to Vit B12 or folic acid defeciency.
hence get a repeat uSg abdomen and serum Vit B12 and RBC folic acid done
Regards
Dr XXXXXXX
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
thank you so much sir..i have already given blood for b12 and folic acid report will come in 2 days and have started taking B12 injection on alternate day.will let you know once report will come ..thank you once again for your kind suggestion
Hi and thanks for the information
Let me know the second ultrasound report also
Regards
Dr XXXXXXX
Let me know the second ultrasound report also
Regards
Dr XXXXXXX
Note: Revert back with your health reports to get further guidance on your gastric problems. Click here.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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