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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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What Causes Abdominal Pain After The Removal Of Gall Bladder?

I am a 25 year old female and I had my gallbladder removed about 4 years ago. During the operation, the doctor clipped the "common bile duct" instead of the "cystic duct" causing me to have a major open surgery to repair the duct and reconstruct everything. Ever since that incident, I have had chronic abdominal pain (around the site of the open surgery incision/scar) mostly under the right side of my ribs as well as uncontrollable and unpredictable nausea and vomiting. However, within the last year or two, I have been getting horrible gas. I have disgusting, foul sulfur smelling burps along with a lot of flatulence but the "episode" would only last a few days and when it would disappear I wouldn't have it again for months. Well, within the last few months, I have had the rotten burps every single day (with maybe 1 day or 2 without symptoms) but it is definitely getting worse. Now, when I get the rotten egg smelling gas and vomit, it feels as though I am vomiting pure alcohol not to mention I have sharp, stabbing pains under the right side of my ribs, I now find myself waking up in the morning with the most awful pain in my back. At first I thought it was the way I slept, but after trying different pillows, different positions, even a different mattress none of that seems to make a difference. The back pain is excruciating! I can't seem to get any answers from my physician. I would just like to know what could be causing this and if it is treatable. I don't know how much longer I can deal with the back & ribs pain. And the burps are incredibly embarrassing. Please help me! I just need to know what all of these symptoms could mean.
Tue, 10 Jan 2017
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General Surgeon 's  Response
Hi,

Clipping the common bile duct during cholecystectomy is one of the most feared complications of this kind of surgery. Can I ask you how your "common bile duct" was repaired during this open surgery? The best long term solution should have been a hepaticojejunostomy, meaning that a piece of the small bowel is connected to the common bile duct if the bile duct is heavenly damaged.

1) If you're suffering from pain since the open operation, then my first suggestion would be to have this checked with an MRCP scan (this is a MRI scan that can check whether the repair of the common bile duct is still ok, meaning no stenosis (= narrowing due scar tissue). For example, after this kind of problem it's important that you're checked regularly (1x/year) to see if everything's allright.

2) I should also recommend to have your stools checked. Some people suffer from pain and some kind of diarrhea due to overwhelming bile salts in the stools. It's called bile acid malabsorption. This can be treated with medicines.

3) When smelly burps like rotten eggs, one must also think of a kind of bacterial or other infection in the bowels. One well know is for example Giardiasis. This is a disease caused by a parasite which gives most of the time diarrhea, but can also cause bloating, abdominal cramps, and sulfur smelling burps. If not cured by itself you need to take medicines. But other possible problems must be ruled out. So I would recommend to visit a gastroenterologist to have this all checked.

Hope this helped. Let em know if I can assist you further.

Regards,
Dr. Koen Vermeiren
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What Causes Abdominal Pain After The Removal Of Gall Bladder?

Hi, Clipping the common bile duct during cholecystectomy is one of the most feared complications of this kind of surgery. Can I ask you how your common bile duct was repaired during this open surgery? The best long term solution should have been a hepaticojejunostomy, meaning that a piece of the small bowel is connected to the common bile duct if the bile duct is heavenly damaged. 1) If you re suffering from pain since the open operation, then my first suggestion would be to have this checked with an MRCP scan (this is a MRI scan that can check whether the repair of the common bile duct is still ok, meaning no stenosis (= narrowing due scar tissue). For example, after this kind of problem it s important that you re checked regularly (1x/year) to see if everything s allright. 2) I should also recommend to have your stools checked. Some people suffer from pain and some kind of diarrhea due to overwhelming bile salts in the stools. It s called bile acid malabsorption. This can be treated with medicines. 3) When smelly burps like rotten eggs, one must also think of a kind of bacterial or other infection in the bowels. One well know is for example Giardiasis. This is a disease caused by a parasite which gives most of the time diarrhea, but can also cause bloating, abdominal cramps, and sulfur smelling burps. If not cured by itself you need to take medicines. But other possible problems must be ruled out. So I would recommend to visit a gastroenterologist to have this all checked. Hope this helped. Let em know if I can assist you further. Regards, Dr. Koen Vermeiren