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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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What Is The Treatment For Severe Abdominal Pain?

Hy, just tell me, please, some causes for sudden abdominal pain, very intense, accompanied by very high level of transaminases (more than 1,000 UI and, paradoxically, normal histological aspect of liver biopsy; saturnism, porphiria, other intoxication wewrw excluded; the crisis last 2 - 3 days and liver transaminases are completely normal after and between crisis. Thank you!
Mon, 23 Feb 2015
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General Surgeon,  's  Response
Hi.
Thanks for your query.
Read and tried to understand the history you have provided- this is very rare to have such a problem, viz . sudden and intense abdominal pain with highly raised transaminase more than 1000 IU and normal histological aspect of the liver and exclusion of other causes as you mentioned.
The crisis lasting for 2 to 3 days only to have everything back to normal.

Such cases are very rare and I would suggest you the following:
All the investigations should be done when you are in an attack of pain.
MRCP and ERCP can help for the diagnosis and treatment.
The newer ultrasonographic ultrasound is a very good modality.

The possible causes are:
Acute hepatic damage due to unknown etiology.
Which recovers very fast.
Also would like to have all the detailed reports of the liver function tests. Particularly the alkaline phoshatase, Pancreatic enzymes too.

Consult a Gastroenterologist to have a more clear thought as he will examine you in details and ask for further tests.
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What Is The Treatment For Severe Abdominal Pain?

Hi. Thanks for your query. Read and tried to understand the history you have provided- this is very rare to have such a problem, viz . sudden and intense abdominal pain with highly raised transaminase more than 1000 IU and normal histological aspect of the liver and exclusion of other causes as you mentioned. The crisis lasting for 2 to 3 days only to have everything back to normal. Such cases are very rare and I would suggest you the following: All the investigations should be done when you are in an attack of pain. MRCP and ERCP can help for the diagnosis and treatment. The newer ultrasonographic ultrasound is a very good modality. The possible causes are: Acute hepatic damage due to unknown etiology. Which recovers very fast. Also would like to have all the detailed reports of the liver function tests. Particularly the alkaline phoshatase, Pancreatic enzymes too. Consult a Gastroenterologist to have a more clear thought as he will examine you in details and ask for further tests.