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Urgent Care (Expert Forum)
Post Op
Answered by
Jeffrey S Guy, M.D., M. Sc. - Burn Surgery, Trauma Surgery, Critical Care Medicine, Med Spec/Interest 4 General Surgery, Pre-Hospital Care
Vanderbilt Burn Center
MEDICAL EMERGENCY- CALL YOUR DR. or 911! This forum is for questions and support regarding urgent care issues such as: Abscess, Angina, Animal Bites, Bronchitis, COPD, Cuts, Flu, Food Poisoning, Heart Attack, Mono, Influenza, Laceration, Nausea, Pneumonia, Rabies, Sports Injuries, Strep.
Post Op
by AndiJ78, Oct 21, 2007 12:18PM
I had my gall bladder removed on Friday via a lap. They used CO2 and removed as much as possible when they finished. I was told the pain would last no more than 24 hours but I am still having significant pain under my right collarbone that radiates through my shoulder, up my neck, and down my arm. Is has caused enough pain to cause difficulty in taking a normal breath. It isn't constant, but is frequent. Is this normal?
I am unable to really use my right arm as a result, cannot lay down, cannot bend over. I have used heat applied periodically, but it doesn't always work.
Any suggestions?
I am unable to really use my right arm as a result, cannot lay down, cannot bend over. I have used heat applied periodically, but it doesn't always work.
Any suggestions?
Doctor's Answer
by Jeffrey S Guy, M.D., M. Sc., Oct 21, 2007 01:10PM
, Oct 21, 2007 01:10PM
Pain After Cholecystectomy:
The surgeon fills the abdomen with carbon dioxide. At the end of the operation, they surgeon releases the carbon dioxide. If any carbon dioxide remains it is absorbed typically within 24 hours. Should pain that you describe is not uncommon following a lap chole. Bile, blood, or fluid can accumulate around the liver, irritate the diagram and cause what is known as referred pain in the area you describe. Less common causes include air in the chest from the inflation of the abdomen with carbon dioxide and inflammation of the pancreas from passing a gall stone down the pass the pancreas. Complications from leakage are rare and can cause postoperative pain. As a surgeon, I can tell you that surgeons are very uptight. Someone is on call for your surgeon, and if you were my patient I would want a call. I would call the answering service and discuss this with your surgeon. The majority of times such pain is very benign, but on occasion such pain requires further investigation.
The surgeon fills the abdomen with carbon dioxide. At the end of the operation, they surgeon releases the carbon dioxide. If any carbon dioxide remains it is absorbed typically within 24 hours. Should pain that you describe is not uncommon following a lap chole. Bile, blood, or fluid can accumulate around the liver, irritate the diagram and cause what is known as referred pain in the area you describe. Less common causes include air in the chest from the inflation of the abdomen with carbon dioxide and inflammation of the pancreas from passing a gall stone down the pass the pancreas. Complications from leakage are rare and can cause postoperative pain. As a surgeon, I can tell you that surgeons are very uptight. Someone is on call for your surgeon, and if you were my patient I would want a call. I would call the answering service and discuss this with your surgeon. The majority of times such pain is very benign, but on occasion such pain requires further investigation.
Ugh, frequent significant pain from your right collarbone radiating to your shoulder, neck and arm must suck.
Jeffrey is right, this is unfortunately common after lap chole. The fluid can irritate the diaphragm (the muscle below your lungs) and there's a nerve there that can make the pain go up to the shoulder area.
Take Jeffrey's lead and call your surgeon, they'd happily answer questions about it and really really want to know about it.
Thanks for your helpful advice! Great to see you Dr. Choi!
I'm sorry you have pneumonia. It would really suck to have a pneumothorax (collapse of lung) and I hope everything goes well with your visit.
No offense to surgeons, while he did the surgery alright, he has no idea what to do to treat someone medically. I was a nurse and had to walk him through everything yesterday ; ) Nice guy, but once the cutting was done he was lost. I will just follow up with my own PCP for the pneumonia and sinusitis.
Thanks again.
The sinus infection and swollen navel--- hmm.
Two things to keep on your radar:
A remote infection will increase the likelihood of developing a surgical site infection. What does that mean? A person with a urinary tract infection (UTI) has a higher rate of surgical wound infection than a person without a UTI. The same is true for sinusitis or any other type of remote infections. Therefore, with a sinus infection, your surgical port incisions have a greater likelihood of becoming infected.
The red and swollen navel is something that needs to be followed carefully. Most surgeons remove the gall bladder through that incision. The gall bladder contains bile that routinely has bacteria in it. Therefore, that navel or umbilical wound may have been seeded from the gall bladder or from the remote infection of the sinuses.