I have a dull pain in my upper right quadrant of stomache,

[Shannonk]

I recently had a my gall bladder removed.  About 4 weeks after surgery, I started having a dull ache in the upper right Quad. of my tummy.  It is below my ribs and closer to the right side of my diaphram.  I have had a CT scan of this area along with an ultrasound.  I have 4 ulcers, which I take nexium for.  The ultrasound was normal, but there notable fluid in my tummy from the scan.  When I get this pain it is constant and intense, but I still can not relate it to what I am doing that seems to bring it on.  I get pain in my right shoulder intermittenly at the same time.  Having a stone in my bile duct was ruled out in the ultrasound.  This pain is in the same place, as the pain from the gall stones was, maybe a little higher up, however it is without a doubt a different type of pain.  It is dull like the pain from the stones were, but a different type of dull.  I am worried that this may be my liver now, is it possible that now that the gallbladder is gone, it is hurting my liver in some way?  I know my ulcers are not causing this, as they have a different type of pain.  Can you tell me the exact side affects from having this surgery?  What could of gone wrong.  My surgeon keeps saying it is from the ulcers, I have spoken with my gastreonologist and know the ulcer pain is a different type of pain.  I did not have this pain prior to surgery, and felt very good for almost four weeks after the surgery-less normal opertional pain.  I do not beleive it is just a coincidence and now just have something totally unrelated to the surgery going on (as what my surgeon keeps telling me).  I am convinced this is from the surgery and would appreciate any and all info you can tell me for the removal of gallbladders and any other referencing materials.  One other side effect that has just started as well, is a buzzing feeling in my head, when this starts I also get heart palpitations, this happens very frequently now.  I also get this involuntary tightening and then untightening in my stomache muscles (lasts for about 20 min. and I have had it happen only three times in the last seven days, never before that)  This does not hurt, it is just irritating.  Does this sound like anything that can be diagnosed specifically, what should I do for testing to see what is wrong.

[Kevin Pho, MD]

One consideration would be Sphincter of Oddi dysfunction.  This can present with gallbladder-like pain in those who have had their gallbladders removed.  An ERCP with Sphincter of Oddi manometry would be the most definitive test for this.  You may also want to consider an MRCP which would be a more definitive test to evaluate for any stones in the bile duct.  

In terms of complications, one consideration would be a bile duct leak.  However, the ultrasound should be able to detect significant leaks.  

If ulcers are of a concern, the most comprehensive test would be an upper endoscopy.  I would also check for H Pylori - which is a bacteria associated with inflammation and ulcers.

You may want to discuss these considerations 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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