pain in right lower quadrant with nausea and vomiting
by mother of patient
pain in right lower quadrant with nausea and vomiting with movement. Area tender to touch. this has been ongoing since 4/18/11 . CT shows normal appendix. 2 different blood tests, first 17,000 now at 7,000. abdominal xray normal. Pain described as stabbing always constant but level is worse at times. no fever. BP 90/55. Pelvic ultrasound shows some ovarian cysts with no pain. Inter muscular steroid injection given with no relief.Patient is 33 year old female. Any suggestions?
It's one of the doctors from the abdominal pain team here. Thanks for using our free online discussion forum.
There is clear evidence there that some form of inflammation had occurred, which is now clearing off as shown by the blood count (CBC) of 17,000 now down to 7,000.
It is most likely a case of local inflammation of the colon (cecum) that could have been caused by a brief cecocolic torsion with ischaemia or from a localized bout of inflammatory colitis.
Is there any family history of inflammatory bowel disease like ulcerative colitis?
It's a shame that the pain is still there, but it is very probable that in the next few days things should be getting better.
Most of the time, a cause of abdominal pain will never be found. The most important thing in all cases is to exclude potentially dangerous causes of the pain. Having been seen by a doctor, had CT scan as well as ultrasound scan, coupled with improving blood results, it seems things can only get better.
If in the next 3 to 5 days she is not better, she would need a re-evaluation.
I hope this helps. Please do not hesitate to come back to us again, should you have any other specific questions.
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