What Do These Ultrasound Of Abdomen And Pelvis Indicate?

Posted on Sat, 6 Dec 2014

Question: I have frequent abdomen pain at center below rib. some times, Gas and fullness feeling at lower abdomen. Some times, urge for bowel movement with some pain. At times,feel quite normal without any symptoms. This is going on since more than two years
BP 102/64 Pulse 64 per minute No cardiovascular abnormal symptoms Weight 107 Lb No diabetes No Thyroid problem.
My abdomen ultrasound test showing Gall Bladder Stones. Colonoscopy Normal. Upper GI Endoscopy Normal. Pelvic US Trans abdominal and Trans vaginal-Unremarkable pelvis and contents.
My doctor's advice is surgery for removing Gall Bladder.
I have doubt that my symptoms will alleviate with the surgery or not and there may be other reasons for my symptoms. Please guide me.

Answered by Dr. T Chandrakant (5 hours later)

Brief Answer:
IBS - Gallbladder removal may help in part

Detailed Answer:
Hi.
Thanks for your query.
Read your history and noted the reports you have posted - dated 4/2/13 and Oct 16 2014.

The one on 4/2/2013 shows gall stones without any inflammation, kidneys normal.
The one on Oct 16 2014 shows similar findings but with small Kidneys. This worries me a lot. You should have consulted a Nephrologist by now and undergone the relevant blood and urine tests.

Re-read your problems- All the problems considered together with normal scopies and USGs, your symptoms are more suggestive of Irritable Bowel Syndrome (IBS).
I would advise you to take Gastroenterologist opinion if not yet taken and start the treatment for IBS.
Stress and anxiety are one of the most important contributors in some cases.

Your symptoms may not alleviate with gall bladder surgery.
Yet it is advised to get the gall bladder removed as it has multiple stones and smaller ones can cause slippage into the ducts causing surgical jaundice or pancreatitis and the stone can cause infection and inflammation of the gall bladder itself. Since you are fit now, it is better to get it removed.
And it is possible that some of the symptoms may get alleviated , particular gases and fullness.

I hope this answers your query, please feel free to ask for more if you need to.

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

Follow up: Dr. T Chandrakant (11 hours later)

About Report Oct 16 2014. I did blood and Urine test on advice of my Primary Care Physician. They are normal. I am attaching those report now. I did Ultrasound again at a different Lab. As per second opinion my kidneys are normal. I am attaching that report too.
Please guide me if I still need to consult a Nephrologist before going for Gall Bladder Surgery.
I understand that Gall Bladder removal will help me in part and it will save me from future complication of Gall Bladder stones. Will the surgery increase my IBS symptoms or may cause other problem?
Please let me know if you have any other suggestions.
Thank you.

Answered by Dr. T Chandrakant (15 minutes later)

Brief Answer:
Nephrologist - yes ! Surgery may help.

Detailed Answer:
Thanks for your feedback.
Sorry to say that the other fresh report is not yet attached / I can not see on my screen. If you would like you can email the report to YYYY@YYYY and ask them to upload it to query 149783.

The report of 16 Oct 2014 says Cholelithiasis without gall bladder thickening and small bilateral kidneys with right extra-renal pelvis.

It is better to consult a Nephrologist as this can be a most important decision.

Please post the report of the second opinion.

Given a normal course, uncomplicated surgery, cholecystectomy should not worsen your IBS or cause other problems.

Please go ahead with as already explained, surgery and medical treatment for the IBS.

Above answer was peer-reviewed by : Dr. Vinay Bhardwaj

Follow up: Dr. T Chandrakant (4 hours later)

Hi, I have provided some attachments. Please review them.

Answered by Dr. T Chandrakant (3 hours later)

Brief Answer:
read the reports

Detailed Answer:
Thanks for the reports:

Nice to know the kidneys are normal, Leukocyte esterase is positive due to normal urogenital bacterial flora and further work-up is needed as per the reports. Glucose is just above the normal but not found in urine. You may repeat the glucose - fasting and post-lunch later.

Above answer was peer-reviewed by : Dr. Bhagyalaxmi Nalaparaju

Follow up: Dr. T Chandrakant (59 minutes later)

Thank you for your answer.
Glucose is just above the normal as it was after taking breakfast (not total fasting) otherwise within normal limit.
Please make final comments on my following conclusions.
No urgent necessity to consult a Nephrologist but monitoring kidney function may be necessary in consultation with my PCP..
Leukocyte esterase is positive due to normal urogenital bacterial flora. Which I will discuss with my Primary Care Physician in Next appointment if it is not urgent.
I will go for a cholecystectomy
Thank you again for your useful and expert answers.

Answered by Dr. T Chandrakant (14 minutes later)

Brief Answer:
Perfect plan, Madam.

Detailed Answer:
Thanks for your appreciation, Madam.

I fully agree with your plan:
No urgent necessity to consult urologist, Leukocyte esterase due to normal flora and discuss with PCP.

Wishing all the best for Cholecystectomy and great health.
Have a great day, Madam. You may please rate this answer if you liked it.

Thanks again.

Note: For further follow up on digestive issues share your reports here and Click here.

Above answer was peer-reviewed by : Dr. Bhagyalaxmi Nalaparaju