Pain in the left of abdomen for 3 weeks

by Nilo
(Tucson, AZ USA)

My wife was hospitlized for 3 days. She had abnormal low blood pressure. She was kept on morfine for pain on the left just below rib cage down to lower side. The pain at times extends to the back. She is overweight diabetic with high blood pressure. At the hospital she was given numereous tests. Doctors determine I think errorneously that she had diverculitis. She was treated with antibotics and released. Her pain returned as soon as the morfine effect ended. My wife told the doctors that she felt it was her ovaries or her tubes. The doctors disregared this because she wasn't bleeding. I remember my wife mentioning menstrual pain about 2 months ago. She had partial hysterectomy 33 years ago. She is 59 years old.

Hi Nilo,

I am sorry to learn about your wife's hospitalization.

I can sense that the cause of her pain still seems elusive. What tests did she get done - blood tests, x-rays, scans?

I note that you said she is 59, and has had hysterectomy. may I ask why she had the hysterectomy?

Also, I know you want answers, and this is not the time to read long list of possibilities. If you don't mind though, I think the best way to help narrow down the likely causes of this "pain in the left of abdomen" of your wife is to quickly list and go through the most likely causes and see if you can relate to any of these.

Pain on the left side of the abdomen just below the rib cage that sometimes spreads to the back could be from a number of conditions including:
  • Left lower lung infection. Is she coughing? Is there any problem with breathing? Being diabetic predisposes her to developing infections than what is normal. Has she had a chest x-ray to exclude this?

  • Left kidney Infection. This could cause her to feel very unwell, vomiting and not able to keep any food down. Has she had a scan? Rarely, kidney tumour could also be a cause of pain in this site too. These
    are easily identifiable with urine tests and scans - ultrasound scan or CT scan of the abdomen and kidneys.

  • Spleen problem. This is not very common, but can cause pain in this area, espcially if it is involved with some other diseases. Again, a simple ultraound scan or CT would show up most problems here.

  • Bowel problems. This could be from things like ischaemia of the bowel - ischaemic colitis , to twisted bowel. Diverticulitis is one of such problems, and can be a rather common problem. This can cause fever, pain on left lower abdomen, feeling bloated, watery stools with or without blood and or mucus, and can be picked up on a CT scan.

  • Left sided psoas muscle abscess. The muscle that lines the floor of the sides of teh abdomen often gets infected with abscess collecting inside it. This causes pain in the left of abdomen, if it is on the left side, fever, pain on the side involved and patient could be really unwell. A CT scan will show this up.

  • Ovarian cyst. Ovarian cysts tends to be rare after menopause. I take it that your wife has already stopped seeing her menses. It is still a possibility though, even in post menopausal women. A scan will help identify this.

  • Endometriosis. Closely related to ovarian cysts, even when the uterus have been removed, is endometriosis. But this condition should not cause her to be terribly unwell, apart from pain.

I am not sure if any of the above conditions and their symptoms rings a bell. How is she now?

Please discuss with your wife's doctors again and see what they have done, what they think and perhaps discuss any of teh possibilities listed here that you think might be the problem with them. They should have no problem taking your thoughts into consideration.

Thank you for using our free online consultation services and I hope your wife's Pain in the left of abdomen for 3 weeks thus far gets diagnosed and treated soonest.

Please kindly update us, if you can, on how things went.

Best Wishes.

Dr O Edema

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