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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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What Causes ULQ Abdominal And Back Pain With Outbreak Of Red Rashes?

First, Thank you. It s a series of symptoms starting in Feb 2016to now. I am 60 non smoker, eat very well, not overweight , no medications. Never sick - last flu was 10 yr ago. YYYY@YYYY 1)Started the end of Feb 16 ...severe pain in L lower rib- upper L quadrant. Thought I had broken my ribs. 2) Two weeks later awoke late at night, couldn t breath - was diagnosed with Pneumonia...by PA. Took first antibiotic in 25 yrs K-Pac.- 5 days. Pneumonia?/coughing cleared. 3) A week later my back left side where pain was/is ....broke out in very red itchy rash - shingles they say! That fairly much cleared up - painful but now just itchy red rash which spreads up down L side...also now R. But not like a shingles rash now ....just red itchy spots. 4) Was feeling somewhat better BUT ---my digestion/regularity lots of /bloating! ...very out of sorts. 5) Then a week ago my whole diaphragm area very painful - left & right & in front.No back pain at all. Now, cannot lift anything heavy, move easily, and am very tired ...but all feels like it in the ribs. Sternum now also a bit painful. No seeming Gall Bladder or liver pain. 6)The pain seems to really be worse in lower outer ribs....now on both sides - though does hurt on breathing when thr lungs expand. If you cupped your hands and held the lower outer rib area ---both sides --- if I press inward it s extremely painful. Thank-you for any thoughts you may have.
Tue, 25 Feb 2020
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General Surgeon 's  Response
Hi,

Noted detailed history about a 60 year old male apparently healty before the cascade of symptoms and diseases crept up starting with pain in left upper quadrant of abdomen and lower chest, diagnosed as pneumonia and got treated with K-pack, pain to nearby areas, then shingles, now the pain as you have well explained.
There looks to be different problems started together or one by one to culminate into the present position.
I would advise you the following in such a situation with reasoning:
CT scan of the chest with contrast to know the status of Pneumonia, whether pleurisy is present, inflammation of the ribs and muscles and so on. This also shows upper abdomen thus helps in visualization of liver, gallbladder, pancreas and so on.
Clinical examination by a Doctor can help a lot in correlating the clinical picture with the investigations and thus pinpointing the cause and have proper management.
Costochondritis is another possibility.
Also get checked to rule out hypertension, diabetes, thyroid related problems, renal and liver functions.

Hope I have answered your query. Let me know if I can assist you further.

Regards,
Dr. T. Chandrakant, General Surgeon
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What Causes ULQ Abdominal And Back Pain With Outbreak Of Red Rashes?

Hi, Noted detailed history about a 60 year old male apparently healty before the cascade of symptoms and diseases crept up starting with pain in left upper quadrant of abdomen and lower chest, diagnosed as pneumonia and got treated with K-pack, pain to nearby areas, then shingles, now the pain as you have well explained. There looks to be different problems started together or one by one to culminate into the present position. I would advise you the following in such a situation with reasoning: CT scan of the chest with contrast to know the status of Pneumonia, whether pleurisy is present, inflammation of the ribs and muscles and so on. This also shows upper abdomen thus helps in visualization of liver, gallbladder, pancreas and so on. Clinical examination by a Doctor can help a lot in correlating the clinical picture with the investigations and thus pinpointing the cause and have proper management. Costochondritis is another possibility. Also get checked to rule out hypertension, diabetes, thyroid related problems, renal and liver functions. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. T. Chandrakant, General Surgeon