Abdomen Pain. CT result and blood test question

[stonefound]

I have had been suffering from primarily right sided abdominal pain for approx. one month. This follows a couple of months of vague UTI symptoms, three visits to Urologists, negative urine tests, and courses of CIPRO and Doxy(suspected prostatitis), and Bactrim (ultrasound confirmed epidydymitis). During these bouts I have had some penile tip pain, and this continued dull pain in my right abdomen, and some post void dribble. This also follows some odd back pain back in December, last year. During that time I also had some odd bouts of low grade fever and general fatigue, lack of appetite, some constipation.

On Jan 19th, I had medial meniscus tear surgery, in a day surgery setting. I asked about having my abdominal pain investigated. The same day of the knee surgery, at the same hospital, I had blood work, urine work, and a contrast CT of the abdomen and pelvis.

The CT results showed a 4mm, nonobstructing right renal calculus, with no hydroephrosis detected. All other imaging was unremarkable. The blood work was deemed normal, (which did happen only about two hours after knee scoping), but after obtaining the results, four values were off of normal.

My questions are:

Could this kidney stone have been causing me any of these other symptoms, even though it is non-obstructing? Is it possible I've had other kidney stones that have been small, but causing me low grade fevers, pain in tip of penis, irregular voiding, constipation, nocturia, etc?

What is more likely? That I have a condition that created the kidney stone (and made me ill) OR that the kidney stone(s) have been making me ill.

What is to be interpreted by the following blood work chemistry:
ANION GAP 5 LOW
LYMPHOCYTE 15 LOW
MONOCYTE 10 HIGH
MANUAL BAND 13 HIGH

Are they still acceptable values, or does that combination indicate something lurking?

Thanks!
Joe

[Kevin Pho, MD]

To answer your questions:
1) It is more likely that the kidney stones are contributing to your symptoms rather than an underlying condition.

2) The blood tests are indicative of an acute inflammatory event (i.e. an infection).  This is likely because of the high count of immature WBCs (high bands).  

I would continue looking for a source of infection.  In the RLQ, the appendix is the most suspicious, and this should be carefully looked at - even if a CT was done.  A spiral appendiceal CT scan can be more sensitive when looking for appendicitis.  

Other tests to consider would be blood cultures, and an ultrasound to evaluate the prostate.

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.
kevinmd_b

[stonefound]

Please also note that I am a non-smoking, non-drinking, 34 yr old male.