waking at night with right upper quadrant pain after lap chole

[mommy01]

I am 5 days post-op from an uncomplicated lap chole last Friday.  After the procedure I had pretty bad right upper quadrant pain that was really apparent with the inhalation part of breathing. The post-op pain is getting better each day and I really don't feel the pain when I breathe during the day.  I have noticed that I wake about 3-4 hours into sleeping with the right upper quadrant pain that is really bad at the level of my breasts but more to the right side.  It really hurts when I take a breath in.  I thought in the begining that it was just because my pain medication wore off but for the last couple of days I have not taken any.  

The strange thing is that for the past 2 nights when I feel the pain I get up and within minutes I feel a really bad pain and an almost popping sensation and the the pain is gone except for a little soreness.  I can only lay flat on my back because it is uncomfortable to lay on my sides.  Could fluid be pooling?  I am so confused because I don't have pain when I breathe during the day other than when I had it the first days post-op.  Why would this happen only a few hours into sleeping and no other time?

[Kevin Pho, MD]

The discomfort may be due to regular post-op healing, but without examination, it is difficult to say.  

You may want to consider an ultrasound to evaluate the right upper quadrant area, to ensure there isn't any bile leak, or some kind of chest imaging to ensure there is no acute problem with the lungs that may be leading to your symptoms (i.e. pneumonia or pulmonary embolus).  

You may want to discuss these options with your surgeon or personal physician.

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.

Kevin, M.D.
Medical Weblog:
kevinmd_b

[tuffs]

this sounds similar to what happend to me after my procedure.  i had a common bile duct injury.

[mommy01]

what did they do for your common bile duct injury?  Was your pain only at night as well?

Thanks!