Digestive Disorders / Gastroenterology Expert Forum
Upper right pain
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Upper right pain

Since my gallbladder removal 12 yrs. ago I have had some occasional pain in that area, but nothing intolerable. However, for the past 6 mos. I have had extreme pain under my ribs on the right side extending from the lower ribs almost to my sternum. I also have a protrusion (lump) on the right which is close to my sternum & quite painful. When lying down for examination my right quadrant is very very tender. I have had the following with negative results: endoscopy, CT with contrast & barium. My routine blood work monitors my hypothyroidism, high triglycerides & elevated cholesterol, but nothing to explain the pain has been noted. Following the procedures, it has been suggested that I explore pain management treatment. I am 62, have had surgery on 4 ruptured disks in my back & handle pain quite well, but his pain (soreness) is a daily occurance. It often presents as sharp knife-like or needle-like stabs and affects the quality of my life. I am 5'7, weighing 145. I am active and not overweight. I know something is wrong. Could it be adhesions? Where should I go now for answers?
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With a normal (presumably upper) endoscopy and CT scan, it makes a GI etiology less likely.  The normal CT scan also suggests that the lump is more superficial.  You may want to consider biopsy of the lump to make sure it isn't cancerous.  Other superficial causes of the lump would be a cyst or abscess.  An ultrasound of the lump can be considered for further evaluation.  A dermatology referral can also be considered.

Regarding the right upper quadrant tenderness, a repeat ultrasound may be considered to evaluate any liver pathology.  With your gall bladder removed, Sphincter of Oddi dysfunction can be considered as a remote possibility.  This options may be discussed with your personal physician who can refer you to a gastroenterologist.  

I agree with surgeon in his comments below that adhesions are unlikely in this case.

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.
1 Comment
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I'd suggest seeing your surgeon; a lump in the area could be a hernia -- easily fixable. Any new lump needs an explanation. What you describe doesn't sound like adhesions.
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