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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Child Has Pain In Right Side. Blood Test And Ultrasounds Clear. Worried About Signet Ring Carcinoma

My 9 year old daughter has been suffering in the last 2 months with severe right side ( loer and upper side) pain intially. Now stomach has been badly affected as she s in pain every time after eating soft food or soups. All blood tests and ultrasound results are clear, still she s not getting any better, still having pain the lower right side and screams in pain every time she goes to toilet( urine test is clear..) I am so worried as endoscopy is not done yet and i worry the worst - signet ring carcinoma ...
Thu, 15 Nov 2012
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Pediatrician 's  Response
Hi,

Thank you for your query.

Kindly correct me if I am wrong in what I have understood:
1. The pain is in the right upper and lower abdomen
2. Pain increases after eating food
3. Pain occurs when she is passing urine
4. Blood and urine tests are normal

What part of the abdomen has been examined by ultrasound - whole or KUB region? What are the clinical findings? Is your daughter constipated? If there is intestinal obstruction due to signet ring carcinoma, as per your suspicion, then there ought to be bloating of the abdomen and vomitings.

By the description it appears that we are missing some thing either in the history or clinical examination. It is advisable to re-assess the child clinically to come to some differential diagnosis whereafter relevant investigations can lead us to a definite diagnosis.

I hope I have answered your query to your satisfaction.

Regards,

RKK
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Child Has Pain In Right Side. Blood Test And Ultrasounds Clear. Worried About Signet Ring Carcinoma

Hi, Thank you for your query. Kindly correct me if I am wrong in what I have understood: 1. The pain is in the right upper and lower abdomen 2. Pain increases after eating food 3. Pain occurs when she is passing urine 4. Blood and urine tests are normal What part of the abdomen has been examined by ultrasound - whole or KUB region? What are the clinical findings? Is your daughter constipated? If there is intestinal obstruction due to signet ring carcinoma, as per your suspicion, then there ought to be bloating of the abdomen and vomitings. By the description it appears that we are missing some thing either in the history or clinical examination. It is advisable to re-assess the child clinically to come to some differential diagnosis whereafter relevant investigations can lead us to a definite diagnosis. I hope I have answered your query to your satisfaction. Regards, RKK