Arm Pain After Gallbladder Surgery

[Mark T]

Dear Doctor,

I had an emergency gallbladder surgery (open) 6 weeks ago. During
the surgery, a bile duct was nicked by the surgeon, and began leaking bile a few days later when I started eating solid foods.

At the time of this leak, I had intense abdominal pain as well as pain in my left arm and shoulder.

A stent was inserted to prevent further leakage, but a pocket of fluid remained. A few days later I was sent home with a bulb drain that I had to periodically empty.

About three weeks later, the bulb drain was removed at which time I started to develop arm pain again. Included with this pain is a numbness in my fingers.

Six weeks later, an ultrasound revealed that the fluid pocket has shrunk by 30%.

The surgeon does not think it is related to my gallbladder surgery, but rather is a problem with my arm position & posture.

However, I did not ever have this problem before and it has persisted for nearly three weeks.

Any information that you can provide for the cause of this pain would be appreciated.

Thanks,

Mark

[Kevin Pho, MD]

Hello - thanks for asking your question.

You may be referring to referred shoulder pain.  It is usually unaffected by moving the arm, and may be associated with symptoms or signs elsewhere in the body.  

Cervical spine or abdominal pathology may initially present with shoulder pain. Patients with myocardial infarction, aortic aneurysm, pulmonary embolus, pneumonia, subacute bacterial endocarditis, ruptured liver adenoma, various malignancies, and well as a number of other conditions may initially present with a complaint of shoulder pain.

Typically gall bladder pain radiates to the right shoulder, not the left.  However, if you are having intra-abdominal fluid, this can certainly irritate the diaphragm, and subsequently either shoulders via the phrenic nerve.

I would evaluate the pain with xrays and perhaps an MRI.  If all the imaging tests are negative, neurology referral would be helpful since you are having numbness.  Electrodiagnostic testing (EMG) would then be considered for further workup.  

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.

[Archi]

I had gall bladder, lap nissen surgery in 2000. I also experienced left shoulder/arm pain for several months. In the hospital, everyone acted like I was crazy and couldn't explain the pain. FINALLY one of the surgeons on a follow up visit explained abour "referred shoulder pain" and said it was likely due to all the gas they used to blow up the area during surgery, unfortuately, when they sew you up, the gas is still in there pushing up on the diaphram and causing the pain. I found the most relief with stuff like pepsid and gas x to help rid the gas.

Good luck  to you...

archi

[Mark T]

Archi,

Thanks for the information.

I did not have laproscopic cholesystectomy (scope procedure), but rather the open cholesystectomy (8" diagonal incision on right side).

Becuase of this, they did not fill my abdominal cavity with gas, so I don't think this is the cause.

But as the Doctor said it might be due to the fluid pocket.

Thanks,

Mark

[PKP82]

Anyone know of a suppliment or med taken after gallbladder surgery for prevention of gas and pain?

[vchav]

I had gallbladder surgery by lipo on 06/17/03.  I have been experiencing severe pain that moves around my stomach.  It is most severe when it reaches by lower rib cage.  The pain radiates to my back near my kidneys.  At first I thought I was having a heart attack.  A CT scan and xrays were done and nothing was found.  

My doctor told me that not all gas can be removed when the surgery is complete and this is what was still in my abdominal cavity.  He also said that my intestines would eventually absorb the gas.  This pain is so severe that my left shoulder hurts when I am going through this pain.  It takes anywhere from 3 to 30 minutes to subside only to return in a few minutes.  Some days I don't have any pain at all.

How long will this last?  I was told 10 to 14 days.  I feel very anxious and feel like I will never be the same again.

Thanks, Viola

[vchav]

Like Archie, I experienced gas pain after I had gallbladder surgery on 06/17/03 by lipo surgery.  After the surgery, I began experiencing severe pain at my lower rib cage and it radiated to my back at the kidney area.  The pain is so intense I thought I was having a heart attack as my left arm and chest hurt and I felt like I could not breath.

After a CT scan and xrays, I was told nothing was found.  My doctor told me it was the gas that was blown into my stomach for the surg. and that eventually my intestines would absorb the gas. It should be gone in about 10 to 14 days.  I hope so, the pain is excruciating.  

A nurse told me to get on all fours and rock as far back and forth as possible to relieve the gas.  It helped only for a while.  Today, I experienced it again.  I am so tired that I could not hold myself up on all fours.  I got very anxious and went outside and walked until the pain subsided (about 30 minutes).  This seemed to do the trick.  I could feel the air bulbs passing to another area of my stomach, for now.    

I would certainly like to hear of any other ideas.

Viola