When to Expect Gangrene

During the week of December 5, I developed right upper abdominal pain while in the hospital following a thyroidectomy. I attributed the RUQ pain to stuffing myself with hospital food for three full days (had been on a low-fat, low carb diet for a few months prior). I was also on a calcium drip and taking calcium supplements. The supplements continued at home for a couple of months until the parathyroids kicked in. Now six months later, I still have the RUQ pain.

I have many diagnoses: bad gallbladder, good gallbladder, adhesions, no adhesions, good colon, redundant colon. Although the diagnoses disagree, all my doctors insist that I see a surgeon. (See Medical Information at bottom.)

So far I

[Kevin Pho, MD]

You have had a pretty comprehensive evaluation for your symptoms.  With the normal HIDA scan and ultrasound, it is unlikely that the gallbladder is contributing to your symptoms.  This is why the surgeons are so hesitant to do surgery.

The inflammation of the small bowel (duedenitis) can contribute to your symptoms.  If the Nexium isn't helping a 24-hr pH study can be considered to evaluate abnormal acid production.  

Otherwise, if the tests continue to be non-revealing, you can look outside the GI system.  A referral to an orthopedist can be considered to evaluate the musculoskeletal system, or a pulmonary physician to look at lung causes.  

Regarding the elevated pancreatic enzymes - a normal MRCP would rule out biliary blockage.  An endoscopic ultrasound can be considered to image the pancreas for any masses.

These options can be discussed with your 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.
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