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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Suggest Treatment For Severe Abdominal Pain

My aunt who is in her 80 s is in ER now with severe pain in lower left quad--food seems to bring pain on, worse when up. Has done EGD, Colonoscopy, abd US, Cardiac stress test, liver function test, and bloodwork has all been normal (haven t got results of today s bloodwork yet). Had gallbladder removed several yrs ago, checked today to see if there were stones in Common Bile Duct--none. Help please
Wed, 12 Nov 2014
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General Surgeon,  's  Response
Hi.
Thanks for your query and an elucidate history.

It is worrisome to know that all the tests you mentioned have been normal viz- EGD, Colonoscopy, abd US, Cardiac stress test, liver function test, and bloodwork has all been normal- blood work once normal has not much important if done again.

The pain is persistent in a lady of 80 years in spite of the negative tests. When the increasing factors are food and standing up, the most probable causes can be ::
Intestinal obstruction- this can be missed by many tests. Needs to be done by a simple X-ray in the standing position- shows gas / fluid levels. This is possible only if done in a standing position. CT scan can not be done in standing position- it is always done in lying down position so can miss.
Another problem can be a sealed perforation- again very difficult to find on any tests. This need a classical clinical test of '' rebound tenderness'' to be elicited by the Surgeon.
So take a second opinion of a Surgeon dealing in Gastroenterology and the cause may be found and well treated .
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Suggest Treatment For Severe Abdominal Pain

Hi. Thanks for your query and an elucidate history. It is worrisome to know that all the tests you mentioned have been normal viz- EGD, Colonoscopy, abd US, Cardiac stress test, liver function test, and bloodwork has all been normal- blood work once normal has not much important if done again. The pain is persistent in a lady of 80 years in spite of the negative tests. When the increasing factors are food and standing up, the most probable causes can be :: Intestinal obstruction- this can be missed by many tests. Needs to be done by a simple X-ray in the standing position- shows gas / fluid levels. This is possible only if done in a standing position. CT scan can not be done in standing position- it is always done in lying down position so can miss. Another problem can be a sealed perforation- again very difficult to find on any tests. This need a classical clinical test of rebound tenderness to be elicited by the Surgeon. So take a second opinion of a Surgeon dealing in Gastroenterology and the cause may be found and well treated .