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What Causes Right Lower Quadrant Abdominal Pain?
Question: My 15 year old daughter is having pain in the right lower abdomen area and is having white and very pale stools when she is going to the bathroom. She no longer has her gallbladder, that was removed 2 years ago. What could possibly be going on with her.
Brief Answer:
Additional information required
Detailed Answer:
Hi
Welcome to Healthcare-Magic
Greetings of the day
Presence of right lower quadrant pain especially if associated with nausea/loss of appetite and fever possibility of Appendicitis needs to be considered.
I would require additional information for me to be able to tell you definitely what it could be
1. How long has the pain been present, is it continous or intermittent?
2. Since how long has she been passing pale white stools
3. Any associated fever?
4. Is she eating well?
5. Is she having a sick look or is okay?
6. Loss of appetite?
7. Nausea or vomiting?
8. Does she have Urinary complaints like burning while passing urine , high coloured urine
9. Is she constipated?
Kindly get back to me with the details so that I am able to assist you further.
Take care
Best Regards
Dr Deepak Kishore
MBBS, MS, MCH
Consultant Pediatric Surgeon
Additional information required
Detailed Answer:
Hi
Welcome to Healthcare-Magic
Greetings of the day
Presence of right lower quadrant pain especially if associated with nausea/loss of appetite and fever possibility of Appendicitis needs to be considered.
I would require additional information for me to be able to tell you definitely what it could be
1. How long has the pain been present, is it continous or intermittent?
2. Since how long has she been passing pale white stools
3. Any associated fever?
4. Is she eating well?
5. Is she having a sick look or is okay?
6. Loss of appetite?
7. Nausea or vomiting?
8. Does she have Urinary complaints like burning while passing urine , high coloured urine
9. Is she constipated?
Kindly get back to me with the details so that I am able to assist you further.
Take care
Best Regards
Dr Deepak Kishore
MBBS, MS, MCH
Consultant Pediatric Surgeon
Above answer was peer-reviewed by :
Dr. Prasad
She had her exploratory surgery for ovarian cyst a month and half ago (if that helps). She has been experiencing this pain for a couple of months. They thought it was ovarian cyst but with the surgery she was cleared of that. However, within the last 3 weeks the pain has come on stronger. We took her to the ER 2 weeks ago. They took a urine sample, blood work, a pelvis exam, and a CT scan for appendix. The radiologist told us to wait 2 hours after drinking the contrast, but they came got her 20 mins later and did the scan but said her appendix was fine. She has been still hurting. It gradually builds up to sharp stabbing pains in the right lower side. Wednesday night (next before) she seemed to run a little fever, but I rechecked her an hour later and there was no fever. She is pale, no energy, but drinking a lot. About 4 hours ago she had a bowel movement and it was white and hard. An hour ago she just had another one, it was a light pale almost white colored stool, but it looked to have a blood spot on it (very little blood spot). She is only passing little hard stools at a time. Not having a decent bowel movement. She has had a total of 4 bowel movements today alone. She has had a little loss of appetite but is still eating. She has complained about nausea but hasn't thrown up since last week. No urine issues so far. Her pain seems to continuous for hours. I forgot to mention earlier in my question that she is taking Lexapro for anxiety and Microgestin birth control for cyst.
Brief Answer:
Constipation could be cause
Detailed Answer:
Hi
Dear Ms
In the absence of fever and significant loss of appetite, this present episode is less likely to be Acute Appendicitis. Diagnosis of appendicitis is by good clinical examination, radiological imaging only are for ruling out other associated disease.
From the description so far it appears that her constipation and passage of inadequate quantity of stools is the likely cause, also possibility of subacute intestinal obstruction is to be considered in view of previous surgery which predisposes to adhesion between bowel loops.
I would suggest to get a Sodium Phosphate enema , which will help in evacuation of stools and give the much needed relief.
If the total Leucocyte count is normal it is less likely to be inflammatory condition like Appendicits. I hope during the CT scan Common bile duct was also evaluated.
This is a simple assessment I would provide you, which you can discuss with treating Physician
1. What is clinical impression from physical examination? is there any tenderness in right illiac fossa?
2. Is there any rise in leucocyte count: if its normal its unlikely to be inflammatory pathology
3. What was the intra-operative findings at the time of exploration? was it laparoscopy or open surgery?
Do keep me updated.
Take Care
Regards
Deepak
Constipation could be cause
Detailed Answer:
Hi
Dear Ms
In the absence of fever and significant loss of appetite, this present episode is less likely to be Acute Appendicitis. Diagnosis of appendicitis is by good clinical examination, radiological imaging only are for ruling out other associated disease.
From the description so far it appears that her constipation and passage of inadequate quantity of stools is the likely cause, also possibility of subacute intestinal obstruction is to be considered in view of previous surgery which predisposes to adhesion between bowel loops.
I would suggest to get a Sodium Phosphate enema , which will help in evacuation of stools and give the much needed relief.
If the total Leucocyte count is normal it is less likely to be inflammatory condition like Appendicits. I hope during the CT scan Common bile duct was also evaluated.
This is a simple assessment I would provide you, which you can discuss with treating Physician
1. What is clinical impression from physical examination? is there any tenderness in right illiac fossa?
2. Is there any rise in leucocyte count: if its normal its unlikely to be inflammatory pathology
3. What was the intra-operative findings at the time of exploration? was it laparoscopy or open surgery?
Do keep me updated.
Take Care
Regards
Deepak
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Above answer was peer-reviewed by :
Dr. Vinay Bhardwaj
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