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Upper Right Side Abdominal Pain
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Upper Right Side Abdominal Pain

Starting 3/02, I had constant upper right under rib pain. I went to GI doctor and had upper GI, Ultrasound, liver bloodwork, hydascan done.  Nothing showed up.  I also had CT of the kidneys, since I have kidney stones that have not moved.  One report said "There are 2 calcifications in the right upper quadrant.  Ultrasound of this area showed no stone in either the gallbladder or kidney.  The significance of this is uncertain.  IMPRESSION:  Right upper quadrant calcifications.  These could be within kidney. Further evaluation with non-contrast CT of the abdomen is recommended.

Isnt that contradictory?  My GI doctor didnt say anything about this or order any other tests.

I have since had a CT on the right kidney.  Would this scan the whole right side?  My GI doctor said they have to scan everything, even if the report was just ordered for a kidney CT.

He said there was nothing else to do that was non-evasive for me.

Questions:

1.  Does CT of Kidney have to scan that entire side of body?

2.  My pain was constant for 3 months, now comes and goes every few weeks.  If the calcifications where cancerous, would the pain be constant?

3.  Can calcifications be cancerous?

4.  Do you think these are cancerous if I have no other symptoms?  No abdominal symptoms or otherwise?
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Hello - thanks for asking your question.

To answer your questions:

1) There are several types of CT scans available for the kidney.  It can either be a full abdominal/pelvic CT, which can evaluate other organs, or it can be a renal spiral CT scan which are five millimeter thick cuts are obtained from top of the kidneys to the bladder base.  The spiral CT scan would be the more limited of the two (i.e. more focused on the kidney).  I am not sure which type of CT scan you had performed.

2) Not necessarily.  Depending on the type of malignancy, it can present as either constant or intermittent pain depending on the size and location of the tumor.  

3) Common causes of right upper quadrant calcification would include renal calculi, calcified gallstones, calcified gallbladder, calcified granulomas within the liver and, less likely, calcified visceral artery aneurysms.  The so called "porcelain gallbladder" (i.e. calcifications of the gallstone due to chronic inflammation) is associated with gallbladder cancer.  

4) Without examining you, I cannot comment on whether these calcifications are cancerous or not.  Cancer may be present whether you have abdominal symptoms or not.  

Followup with your personal physician is essential.

This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.

Thanks,
Kevin, M.D.
2 Comments
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I have been experiencing increased pain on my upper right side for months, accompanied by excruciating mid (under ribs) and upper back pain (extending under shoulder blades).
Blood, urine, X-rays, and ultrasounds have shown nothing but a slightly fatty liver.  I am taking Darvocet for the pain, but find that the nausea, fatigue, and pain in my lower abdomen are beginning to interfere with my ability to function at work.  The pain on my right side is concentrated around the area where my gall bladder is located, extending around under my arm, and stabbing through to my back under my shoulder blade.

The pain is not relieved by bowel movement, and increased gas (much more than normal -- even associated with IBS/or lactose intolerance) have become a problem as well.  Please advise.

Thank you,
Christina
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Christina,
I'm NOT a doctor, but it sounds like gallstones.  I had very similar symptoms when I had gallstones(during pregnancy).  It is excruciatingly painful.  I went to the E.R. numerous times before I was diagnosed.  The physicians did x-rays and didn't see anything(and said it was probably heartburn...lol).  Upon ultrasound it was obvious that I had gallstones.  Anyway, if you are in excruciating pain, you need to see your doctor to see exactly what the problem is.  Just my opinion.

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I have also been experiencing upper right pain just under my ribs, and your comments were very helpful. Now I know that I should let my docotr know....thanks everyone!
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