liver hemangioma

Question

I have had issues with pain in the upper right quadrant under my ribs and radiating to my back for the last two years. It feels like I have a ball there and I have to lean to the side when it's really bothering me to give it 'room'. I had some abnormal liver panel results but they told me not to worry about it. They said I had GERD and gave me Prilosec. I was back in a couple of weeks with another 'attack'. Sometimes it doesn't bother me much and other times it's bad. Nothing changed. The doubled my dose and put it at twice a day. I started tracking all of my food and symptoms to see if it was something I was eating. I increased my fiber even though I had no digestive issues. I cut out caffeine and all soda. I felt better for a few weeks and thought maybe they were right...then it was back again. I went back in and was seen by a different Dr who finally ordered and ultrasound where they found 3 hemangiomas in my liver. The Dr told me don't worry about it and take even more Prilosec if my side was still bothering me. I am already taking 2 twice a day. I am frustrated as they insist that it's not my liver that is bothering me. They will do another ultrasound in 3 months to see if they have grown. I KNOW it's not my stomach that is bothering me. I understand that these things don't normally cause pain but is known to happen now and then. It's just very frustrating.

This discussion is related to liver hemangiomas and pain.

antval · Answer

I must agree with debbiec230. I question the medical community on the knowledge being expressed to the patient.
 
In 2012 I had a large (size of a small melon) hemangioma removed from my liver. After living with pain in the right upper quadrant, nausea, vomiting, and stomach swelling for nearly two years! One day an ER doctor mentioned that I had a hemangioma on my liver and might want to consider getting that checked out. From  there I was referred to a local surgeon who looked over many years of scans in my records. He informed me that I had this growing for many years, but that there is nothing to worry about and that it is highly unlikely to be responsible for the symptoms I was suffering. He tried to tell me to just live with it and ignore it. As he tried to send me away I insisted that I could not live this way, the symptoms were stopping my life. He finally referred me for a second opinion to Dr. Richard Schulick at University of Colorado Hospital Denver. I did some research on Dr. Schulick and found that he was the Director of surgical oncology for John Hopkins and had recently taken the job at University as Professor and Chair of Surgery. Dr. Schulick has extensive experience in the subject of liver hemangiomas, not just textbook or passed down knowledge. He showed us the scans of my liver year by year. He explained all the true complications a hemangioma could cause and then recommended surgery. The location and size of the hemangioma made it impossible for a laparoscopic surgery. I had the surgery a few weeks later. This was the best decision I could have ever made! 

Now, whenever I have an appointment with any sort of doctor and the liver surgery topic comes up, I recommend they research his work. I also give them a super quick lesson on the facts of hemangioma symptoms and complications. The symptoms are real and the hemangioma can absolutely be responsible for these symptoms!

busymomofboys · Answer

My husband went through this for about 5 months and it was a nightmare! They thought it was his appendix, but the CT scan showed a liver hemangioma. He had to go to a universtiy hospital because no surgeon in our area was equiped to handle this issue. The liver transplant surgeon told him that the liver hemagioma couldn't be causing his problems. He then went to 2 specialists and 2 surgeons. He ended back at the university hospital and the surgeon finally agreed that because he had exhausted all other possibilites (and a LOT of money), it had to be the hemangioma. They discovered with an MRI that he had 2, the largest being just over 12 cm (it had grown some in just the 5 months between visits). He ended up having surgery (a year ago last October) where they removed 2 of them (we found out after the surgery that he had 3 of them - one was left in him) and his gallbladder because the largest one had attached itself to his gallbladder. Now he is having aches in his chest and did a treadmill stress test. They told him there was some restriction in the blood flow in his heart ventricle and it is uncommon for his age (almost 40). I found this website by trying to figure out if his liver is close enough to his heart that if the 3rd hemangioma left in could have grown enough to cause this restriction. I don't think that is the case with this, but who knows. Either way, doctors do need to pay attention to this issue and realize that hemangiomas do cause more pain and discomfort than they know.

debbiec230 · Answer

As I read this and the other related threads on this site, with a couple dozen patients describing very similar scenarios - and very similar to my own - unexplained upper right quadrant pain, negative gallbladder, negligible (if any) help from GI meds like prilosec or diet change, and all with the presence of one or more liver hemangiomas, I have to wonder whether the current state of medical knowledge is as complete as you (the medical community) think it is.    

At the very least, it seems worth considering a study to see how common the coexistence of idiopathic upper right quadrant pain and liver hemangiona really is.

DrKaul · Answer

Hi there! 
 
Liver haemangiomas are quite common and are benign lesion unlikely to be responsible to ne responsible for the described symptoms. RUQ pin could be related to GI issues such as infection/ inflammation, growths/ masses, GB issues, causes related to the respiratory tract/ chest wall, neuro-muscular causes etc. If GERD/ gastritis management has not been successful, one may consider looking at other possibilities. I would suggest discussing the situation in detail with your treating gastroenterologist and consider a detailed evaluation by an internist to look at other possibilities and suggestion of an appropriate management plan. 
Hope this is helpful. 
 
Take care!