Posted by HFHSM.D.-skb on January 21, 1998 at 22:22:08:

In Reply to: Differential Diagnosis to rule out gall bladder disease posted by Kathy on January 16, 1998 at 10:23:43:

: I have experienced on and off pain in Right upper quadrant of abdomen. Pain usually two fingers lateral of xiiphoid process and next to ribs. Sometimes a dime sized area two fingers lower than ribs is tender to palpation. When symptoms intense, also experience pain rib angle rib twelve and Rt. anterior shoulder. I am also recovering from shoulder injury involving dislocation of first three ribs and tendonitis. Pain began about two years ago at time of ovarian cyst on same side. Pelvic exams do irritate symptoms. Food does not appear to alter symptoms. US of Gall bladder was normal.

Dear Kathy,
Gallstones usually cause abdomen pain in the center of the abdomen between the ribs. Typically gallstone pain is a steady discomfort which gradually increases over 30 to 60 minutes, remains constant for another hour and then gradual subsides. Pain can radiate to other parts of the abdomen, to the back, and to the scapula or tip of the right shoulder. Many older textbooks state that eating fatty foods precipitates the pain associated with gallstones. In the last few years, however, we have recognized that the association between fatty foods and gallstone pain is not as great as had been proposed.

Ultrasound of the gallbladder is considered a very sensitive and specific test for gallbladder stones. If ultrasound of the gallbladder is normal, the likelihood of having gallstones is virtually nil.

Based on the history that you provide, there is the possibility that your symptoms may be related to right ovary and/or other gynecologic problems . A gynecological check-up will help to evaluate this possibility. Because your abdominal pain preceded your recent shoulder injury, it is unlikely that the shoulder problem is causing the abdominal pain.

This response is being provided for general informational purposes only and should not be considered medical advice or consultation. Always check with your personal physician when you have a question pertaining to your health.

If you would like to be seen at our institution, please call 1-800-653-6568, our Referring Physicians Office and make an appointment to be seen with Dr. Batra one of our experts in the investigation of abdominal pain.

HFHSM.D.-skb
keywords: abdominal pain, cholelithiasis, biliary colic
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