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Suggest Treatment For Left Abdominal Pain
66 year old male pain in abdomen located at left side front beltline, pain centered about an inch below and 6 inches to the left of my naval. 243 pounds, 5'10", obese belly. just returned on Nov 23 from California desert camping at Cargo Muchacho Mtns, near Yuma, AZ. At desert camping I had very mild headach and loose brown stools, starting after group "potluck dinner" a few days when camping in desert there, but after Thanksgiving here in San Diego, stools got solid but very soft and brown color, and headach got worse during Thanksgiving day, and a mild pain about diameter of a silver dollar has become more tender and getting worse. Pain level was about 1-2 yesterday with temp 97.7 deg F, now pain 2-3 with temp 98.7 deg F. If sleeping on right or left side or stomach, or sitting position, I can position myself to get pain down to almost zero, but sleeping on back causes pain to increase, and any muscle movement or finger pressure around the affected area causes pain to increase to about 7 level. My appendix burst about Nov 2009, and removed by micro surgery about Mar 2010, so cannot be appendicitus.
Gall stones perhaps? Kidney stones perhaps? Desert Fever or aomeba in colon perhaps? Had colonoscopy about 5-10 years ago, clean as a whistle then, no pollups or cancers. Any ideas?
Gall stones perhaps? Kidney stones perhaps? Desert Fever or aomeba in colon perhaps? Had colonoscopy about 5-10 years ago, clean as a whistle then, no pollups or cancers. Any ideas?
posted on
Fri, 14 Mar 2014
Medically reviewed by
Ask A Doctor - 24x7 Medical Review Team
Fri, 15 Aug 2014
Answered on
Mon, 18 Aug 2014
Last reviewed on
Hi this is dr Subhadeep.thanks for the opportunity to help you.as per your description of the location of the place,it can't be gall stones.gall-bladder is to the right.
it can be a renal stone but then you should have difficulty in passing urine or blood in urine.as u haven't mention any of these symptoms,I assume you don't have problems due to urinary stones.if u have some extra information you can provide.that will help me to deduce a diagnosis.
regarding brown coloured stools it can be due to lower GI bleed which can be due to various reasons as enlisted
1) Angiodysplasia
2) ischemic colitis
3) mesenteric ischaemia
4)acute episode of ulcerative colitis
5)intussuception
6)Malignancy
though colonoscopy done 10 yrs back was normal.there can be changes within the time period of 10 yrs.so a repeat colonoscopy is mandatory.i am interested to know whether you have any cardiac disease misty MI to give a clue for possible vascular insufficiency.why was colonoscopy done in the first case?is there family history of any cancer?kindly get a colonoscopy done and show it to your surgeon.
angiography is better as it can detect a bleeding rate of 0.5ml/min.therapeutic emboli zayin can be done.ct angiogram,nuclear scintigraphy can detect 0.1ml/min bleed.
as you had altered blood (brown stool) you can do an UGI scopy to rule out peptic ulcer.
finally fecal occult blood test,platelet count if low then do serological test for dengue,widely and peripheral smear along with an USG to rule out any enlargement will be helpful.
kindly let me know if you found this consultation helpful
Regards
it can be a renal stone but then you should have difficulty in passing urine or blood in urine.as u haven't mention any of these symptoms,I assume you don't have problems due to urinary stones.if u have some extra information you can provide.that will help me to deduce a diagnosis.
regarding brown coloured stools it can be due to lower GI bleed which can be due to various reasons as enlisted
1) Angiodysplasia
2) ischemic colitis
3) mesenteric ischaemia
4)acute episode of ulcerative colitis
5)intussuception
6)Malignancy
though colonoscopy done 10 yrs back was normal.there can be changes within the time period of 10 yrs.so a repeat colonoscopy is mandatory.i am interested to know whether you have any cardiac disease misty MI to give a clue for possible vascular insufficiency.why was colonoscopy done in the first case?is there family history of any cancer?kindly get a colonoscopy done and show it to your surgeon.
angiography is better as it can detect a bleeding rate of 0.5ml/min.therapeutic emboli zayin can be done.ct angiogram,nuclear scintigraphy can detect 0.1ml/min bleed.
as you had altered blood (brown stool) you can do an UGI scopy to rule out peptic ulcer.
finally fecal occult blood test,platelet count if low then do serological test for dengue,widely and peripheral smear along with an USG to rule out any enlargement will be helpful.
kindly let me know if you found this consultation helpful
Regards
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