What Are The Possible Results In A CT Scan In Case Of Mild Pain Just Below Left Ribcage ?

Posted on Mon, 7 May 2012

Question: 38yr old female, 141lbs height 5'6", active, two previous C-Sections in past 5 years, generally healthy, gall stones present on ultrasound one year ago, take approx 500-1000 mg daily tylenol for arthritis type pain, frequent urination during night for last 10 years, also too 875mg Augmentine 125mg Clauvanate for sinus infection 4-6 weeks ago of which I only took 4 of the 10 prescribed days because it made me very ill (I do not currently have loose stools). Supplements: L-Carnitine, Chaste Berry extract, rhodiola, omega 3, tumeric, reservatrol, vitamin D. Symptoms: pain directly below breastbone on right side (probably gallbladder), mild pain just below left ribcage, mild pain/discomfort on left side/flank which is sometimes uncomfortable to sleep on, shortness of breath when running (shortness is more than usual), the above symptoms have been occurring 4-6 weeks. 2 or 3 months ago I was seen in the ER for severe chest pains that awoke me from sleep. EKG and blood tests were performed, no heart attack indicated. No definitive diagnosis from ER or my XXXXXXX medicine physician. I have seen my physician regarding all of the above and he has ordered a pelvic and abdominal CT scan, which is scheduled for Monday. He also ordered a lot of labs, all of which have been normal. He has not performed a urinalysis. My questions are: What are the possible diagnoses and what is he looking for with the CT scan?

Answered by Dr. Poorna Chandra K.S (4 hours later)

Hi,

We generally follow 'Evidence Based Medicine'. Your doctor is right in ordering these labs and tests. The protocol of tests are being followed.

These are the following possibilities I could think of with your description and no information on tests.
Pain in the lower chest / Upper abdomen with shortness of breath in your case could be due to -
Chest problem - Fluid in the pleural cavity (Pleural effusion)
Heart problem - Inffective pumping with congestion in abdomen and liver
Ulcer ( gastric / duodenum) with anemia secondary to blood loss
Pancreatic inflammation : however there would be a history of severe pain abdomen
In view of arthritis and pain killer use : Gastric ulcer + anemia or lung fibrosis
Gallstone related pain is usually felt in the (R) upper chest, at the shoulder blade and at the tip of shoulder.
Even if the ER had ruled out any cardiac problem, we need to rule out it every time you have a chest pain.
A good physical evaluation and investigations must be able to determine the cause. Please get back to me after the labs and the CT scan.

Regards

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar