My boyfriend has severe pain in the lower left quadrant of his abdomen. It is so severe that he cant put any weight on his left leg or straighten his legs out. No one can touch the area it is so painful. He feels better when he lays down in the fetal position. It is nonstop, 24 hours a day, for the past 5 days. It first occurred on March 10th. He went to the doctor where they did a CT scan. The first time they diagnosed it as an epiploic appendagitis and told him to take 2400 mg of aspirin per day. After around 5 days, the pain went away. Then not even a week later, the pain has come back and worse than before. This time in the ER they gave him dilaudin but he said it really didnt help the pain at all. The CT scan came back with just very very minor swelling, but better than the first CT scan. All of is urine tests and blood tests come back normal. He can barely walk so he cannot go to work. They said it is not diverticulitis or kidney stones. Any idea on what this is or how we can make it better?
It sounds as if it could be a continuation of the EA. Although it's considered a benighn and self-limiting condition, it can occur again and again, unfortunately. Most with the problem are managed conservatively - oral antiinflammatory meds and occasionally a short course of opiates. The antiinflammatory meds can tamp down the discomfort but don't modify the problem.
There really aren't any strict guidelines for therapy, but the suggested is ibuprofen - 600 mg every eight hours for four to six days. In some cases Tylenol #3 every six hours as needed for 4-6 days is given. Most respond in about four to seven days.
Has he tried the aspirin again, or asked the doc if that should be the course of action? Keep in mind that not all 'narcotic-based' meds work for each individual - as strange as that might sound.
Thanks for responding. He is currently not taking anything as he feels nothing helps the pain. The doctors didnt recommend anything besides the dilaudid, as they felt that EA wouldnt reoccur.. the aspirin might be worth a try since it made it reside last time, even if it was only for a little while.
They did find a kidney stone but they said it was too small to cause an obstruction. Is there any possible way a CT scan could have missed another kidney stone?
It's somewhat unlikely that a stone would have been missed, but it can happen.
The problem with the CT scan is the appendices (epiploica) may not be seen on the scan unless they are surrounded by a sufficient amount of intraperitoneal fluid. So if the inflammatory pattern went down over time, torsion may still occur and the condition can continue and not be picked up.
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