What Causes Right Sided Abdominal Pain In Between The Hipbone And Rib Cage?

Posted on Fri, 20 Mar 2015

Question: Hello, female age 42, not pregnant. I've had right sided abdominal pain in the space between the hipbone and bottom of the rib cage for 3 years. It started shortly after my youngest son was born. There have been a few periods of 3-5 days without any pain, about 50% of the time pain is mild and nagging, and about 10% of the time it is intense pain. The remainder is somewhere in between. 2 years ago, ultrasound showed hydronephrosis/megaureter. Cystoscopy revealed a ureterocele which was unroofed, a stent was placed for 2 weeks. Pain never resolved. Finally convinced my Gynecologist I was tired of living with this pain and had CT of abdomen/pelvis, without and with oral and IV contrast last week. The radiology report was lost, then finally found today. His nurse read the report to me over the phone and the only abnormal finding was prominence of the right renal pelvis and proximal ureter dilation. My gyn. doc won't be back until Monday to see the report. No calculi were found. UA, BUN, creatinine were not tested. Could the CT abnormalities be a source of the pain in my side? The pain is sometimes positional (worse when changing positions, walking, twisting), and there is moderate tenderness upon palpation most of the time. RN-Paramedic for 18 years. Thank you for your input.

Answered by Dr. Soumya (45 minutes later)

Brief Answer:
Renal evaluation required

Detailed Answer:
Hi,

I read your query and I understand your concerns about right quadrant pain.

Following is my reply:

1) This pain appears likely to be arising from dilated renal pelvis ureter dilatation.

2) The question that needs to be answered is why there is dilatatiion of ureter and renal pelvis? This happens if there is any obstruction to ureter below.

3) This obstruction is secondary to possible enlargement of ovary or uterus or any other mass pressing it below which needs to be checked.

4) If CT scan is not showing anything conclusive, please ask your doctor if an MRI can be performed.

5) This pain is definitely related to the renal changes as described.

6) Meanwhile I suggest you get renal function test ( blood test ) done. Get UA, BUN, Creatinine which will give additional information required to identify the type of renal lesion. Please get them done today if possible and send me the report.

Let me know if you have anymore questions.

Regards,
Dr. Soumya

Note: For further queries related to kidney problems and comprehensive renal care, talk to a Nephrologist. Click here to Book a Consultation.

Above answer was peer-reviewed by : Dr. Shanthi.E