Brief Answer:
Severe Colicky pain on right lower rib cage/Under Evaluation

Detailed Answer:
Brief Ans-Severe Colicky pain on right lower rib cage/Under Evaluation

Hi Dear,thanks for the query to HCM.

Read and verified facts of your query in context to your health concerns.

I feel concerned,as it happened 2nd time since last attack,10 yrs after your Cholecystectomy,almost causing syncope with it.

In this scenario along with Hemangioma, your case becomes more complex.
Exercise triggered the latest attack but the first one was while sitting down only.

MY Impression about the cause of this stabbing pain-
Based on the above review,Mostly it seems to be due to one of the following causes-

a-Could be from CBD(Common Bile Duct) post- Cholecystectomy obstruction with stricture from adhesions around CBD,with Inspiratory Catch.

b-Could be from Hemangioma as well.

c-Cystic duct remnant Syndrome needs to be kept in mind,as the Gall bladder was removed in your case.

d-Stones in Cystic Duct Remnants -could also cause such a pain and needs to be ruled out
From your history -the first attack(while sitting) seems to be from Hemangioma,
and Second attack(current) seems to be from Stricture CBD.

Investigations Suggested -

CT Abdomen with contrast study-
Or MRCP-Magnetic Resonance Cholangio-Pancreatography-would assess the cause of this acute excruciating pain in right upper abdomen,with inspiratory catch.

Second opinion by a Surgeon/Gastro-enterologist, would be needed to assess your case and treat it accordingly.

To treat the acute painful event with ER Surgeon, with abdominal painkillers like Inj Bentyl (Yes for that you need to visit to the ER).

Hope this would help you to plan treatment with your doctors there and take right decision to treat it soon.

Welcome for any further query in this regard,which I would love to help you out.

Good Day!!

Dr.Savaskar M.N. XXXXXXX Surgical Specialist
M.S.Genl-CVTS

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Brief Answer:
Severe Colicky pain on right lower rib cage/Under Evaluation

Detailed Answer:
Hi,Dear,Thanks for your updates to HCM.
I perceive from your updates,that you are satisfied with the reply and reasoning given for your colicky pain under right rib cage.

Reasons Regarding your Main health Concern and updated in last query from you
-regarding XXXXXXX Horse-with Severe Cramps in legs.
Q-Would the causes you suggest cause the severe cramp as well- like a major twisting XXXXXXX horse? That is where I am so concerned and confused.
Ans-Regarding this question,as you don't have history of any accompanied diarrhea,chances are less.
But the chronic pain and stomach distension,would cause stress on the body system,which may cause hypokalemia ,from malabsorption and from resultant malnutrition.And this may cause XXXXXXX horse in your case.
But for your age,as the chances of Varicose Veins and Diabetes are more,I would suggest You to rule out-Varicose Veins by Color Doppler and rule out Diabetes by Blood Sugar studies, and need to kept in mind while treating your case.
Remedy suggested for -Charlie Horse till investigations are done-
a-Banana with Skimmed Milk Shakes x 2 time per day
b-Sweet Sour Thin skimmed Butter Milk x 2 times per day
c-Porridge of smashed potato x 2 times a day would help you recover severe cramps,which disturb and is main concern in your 2nd update query.

Hope this would reply would calm your worries and anxiety till tuesday,when this information would help you to plan right treatment for your 2 health issues


So Keep Me updated after you visit your doctor and do consult by a direct query to ME at HCM, before you decide on any major action for treating your health problems.

Welcome with any further query in this regard.
IF no you don't have any further query and feel satisfied with this reply,I would appreciate YOU,to write excellent feedback review comments,to rate My services,just to help the needy patient Visitors like YOU,at My Virtual Clinic,at HCM forum.

Wishing you fast recovery for the upcoming X-mas there in Seaforth,NSW,Australia!!
Have a nice Holiday and Happy X-mas in advance.

Good Day!!
Dr.Savaskar M.N. XXXXXXX Surgical Specialist
M.S.Genl-CVTS

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