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Re: upper right quadrant pain
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Re: upper right quadrant pain

Posted By kenn on June 04, 1999 at 02:21:03
Dear doctors, I was diagnosed with Hepatitis A 9 months ago (Sept. 1998)after becoming ill in Mexico following a long travel excursion. I experienced symptoms generally associated with Hep A (i.e. jaundice, loss of appetite, nausea, headaches,etc) but no pain in the upper right quandrant until three months after being ill and after my other symptoms had long disappeared. This pain continues to bother me nine months after the initial illness. It is a dull pain that bugs me on and off but fairly persistently. Other symptoms included dry throat and mouth and eyes. I was checked for diabetes in March and the test was negative. In March I visited a physician who conducted blood tests on me. My liver function tests came back normal, however my IGg test came back inconclusive. I have since continued to experience the pain although ultrasound and x-rays that followed were normal as well. My doctor seems to think that the pain may be due to a liver still in the process of regenerating. Does this seem likely? Is an IGg inconclusive test normal? What questions should I ask of the doctor on my next visit concerning other tests or approaches we may consider? Thank you very much for your time, much appreciated.




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Posted By HFHSM.D.-D.M. on June 10, 1999 at 15:35:43

Dear Kenn:
I am intrigued by your story.  You developed hepatitis A while traveling in Mexico.  It sounds like you recovered from the hepatitis A but you now have persistent right upper quadrant pain that wont go away.  Youve had some lab tests and an abdominal ultrasound that was normal.
First, I am not sure what the IGg test is and I am not sure how to interpret an inconclusive IGg test.  There are a couple of tests I can think of that you might be referring to but I feel uncomfortable speculating.  If youd like you can try to get me a little more information about this test and than I can comment.  
I am not sure what is causing your pain.  I can tell you that there are no long term consequences of hepatitis A.  I cant rule out that the symptoms are due to a regenerating liver though I have no way of confirming that.  The symptoms of a dry mouth and dry eyes are somewhat non-specific.  I am pleased that your liver tests have returned to normal.
Right upper quadrant pain can be difficult to pin down.  The different possibilities depend upon the nature of the pain, the location, are physical examination, other symptoms (fever, weight loss) and whether the pain is relieved or worsened with food.  Common possibilities include rib or chest wall inflammation, stomach upset (ulcers or gastritis), pancreatitis and gallbladder problems.  Travelers to Mexico can develop something called an amebic (amoebic) abscess in the liver although that is usually seen by the ultrasound.  In addition, some sexually transmitted disease can cause irritation of the liver and liver lining.  
What we often do with chronic abdominal pain is to move to rule out obvious cases and life-threatening causes, we then focus on less serious and more unusual causes and symptom control.  Sometimes, we see how things evolve over time.  If symptoms resolve, we let the problem be.  Otherwise, we do additional tests based on how the symptoms and signs dictate.  
I hope this information is helpful to you.  Good luck with your situation.  If you have additional information or questions, I would invite you to post the material to MEDHELP.  The direct number to our Liver Clinic at Henry Ford is (313) 916-8865. We have an active group of liver specialists and gastroenterologists.  
This response is being provided for general informational purposes only and should not be considered medical advice or consultation.  Always check with your personal physician when you have a question pertaining to your health.  











Follow Ups:


upper right quadrant pain BEVERLY 6/23/1999
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Re: upper right quadrant pain HFHSM.D.-D.M. 6/27/1999
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upper right quadrant pain kenn 7/02/1999
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Re: upper right quadrant pain HFHSM.D.-D.M. 7/11/1999
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