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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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What Causes Low To High Intensity Pain In Upper Central Abdomen?

Low to high intensity pain in upper central abdomen from past four days intensity of pain rising as days pass by. History of portal vein collaterals alongside mildly enlarged spleen( diagnosed in 2005 but spleno renal shunt was not done due to unclear situation of portal vein even after mri s and ct scans ultimately discharged), and gilbert s syndrome (detected in2014), had a little bit gas problems in past (not so severe). Medication since 2014: Ursocol 300(not so regular throughout the year buttaking 1 tab regularly from past month), ligand sb(same as ursocol). Yestarday lft : Bilirubin ( indirect 17.92, direct 14.31), haemoglobin 14.68) , shot:120,sgpt:189,Alkaline phosphate:186,A:G ratio:2.32, prothrombin time:11.90,international normalized ratio:1.16; haemogram- red cell distribution width:16.30,Differential leucocyte count- lymphocytes:19, absolute leucocyte count- lymphocytes:0.86 and platelet count 62.0. Kft- urea:14, alkaline phosphatase:18.5, A:G ratio:2.37, phosphorus:1.90. Having treatment in aiims since 2005,2006 ( didn t follow up till 2014) in 2014 I had some infection in July leading to high bilirubin levels ( around 11indirect) along with green diarrhoea stools for some days then got well. Now unwell from past 4 days having dark urine and mild coloured stools sometimes with a greenish tint. The above lfts and kfts mentioned are the abnormal highlighted values (except haemoglobin). Please help as the pain is unmanageable. Went to aiims emergency last night but they said no bleeding and asked to take a pentacid tablet. Went to opd today but they again asked to take pentotab.
Mon, 3 Aug 2020
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General Surgeon 's  Response
Hello,

Significantly raised direct bilirubin indicates surgical jaundice which is also known as obstructive jaundice. It is best recommended to get an ultrasound of the abdomen and pelvis to evaluate the following:
- Gall bladder
- Liver
- Intra and extra hepatic biliary system
- Pancreas
- Pancreatic ducts

Take care. Hope I have answered your question. Let me know if I can assist you further.

Regards,
Dr. Bhagyesh V. Patel, General Surgeon
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What Causes Low To High Intensity Pain In Upper Central Abdomen?

Hello, Significantly raised direct bilirubin indicates surgical jaundice which is also known as obstructive jaundice. It is best recommended to get an ultrasound of the abdomen and pelvis to evaluate the following: - Gall bladder - Liver - Intra and extra hepatic biliary system - Pancreas - Pancreatic ducts Take care. Hope I have answered your question. Let me know if I can assist you further. Regards, Dr. Bhagyesh V. Patel, General Surgeon