abdomen pain progressing

About 5 months ago Inoticed abdomen discomfort. It was a dull and I found my self subconciuosly pushing on the area.I brought it to the attention of my pcp would treated gerd like symptoms approach. About three months went by,some blood test ekg, cholesterol etc and things got worse.Iended up in the emergency room with severe abdomen pain and it was there that my history became a possible link to my presenting problem. At age twelve 25 yrs ago I was in a dirtbike accident and took the end of a handle bare in the stomach.As a result I ha a traumatic avulsion of the duodenum with massive contusion to the head of my pancreas.My new pcp is leaning toward adhesion as the culprit but its tough to say I guess. Alot of uninvasive test have not been remarkable,ct-scan,upper gi,x-rays, etc.I am scheduled for an upper endoscopy but feel like this will also be neg. My symptoms now include massive cramping across my abdomen that radiates up my left side seemingly into my shoulder.I guess my question is 3 parts,how shall I best advocate for myself when tests are proving negative, two, do you feel that I am on the right track, and finally if it is adhesion do you have any helpful suggestions?
ps. Iguess this is mor like $4.00 a question

Thanks, Willy27

[Kevin Pho, MD]

I agree with the workup thus far, including the CT scan and upper GI.

Indeed, the upper endoscopy would be a reasonable next step, and caon comprehensively evaluate the esophagus, stomach and proximal part of the small intestine.

If the tests remain negative, an MRI or endoscopic ultrasound can be considered if there is suspicion of pancreatic damage.

If an adhesion is responsible, it normally would be picked up with the imaging studies you have had.  If this is the case, a surgery referral would be necessary.  

I would consider a second opinion with a GI physician, preferably at a major academic medical center.

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 Pho, M.D.
www.kevinmd.com
www.twitter.com/kevinmd