abdominal pain but nothing shows on ct scan
She has experience in primary care and hospital medicine. If you want to get notified by every reply to your post, please register. While these tests are designed to efficiently and accurately identify abdominal and pelvic emergencies, the list of non-life-threatening diagnoses that can cause pain is much longer, and unfortunately requires specialists and testing that we do not have in the ED. Have you talked with anyone about the possibility of an obstructed bowel? I would try and get ultra sound done of pelvic area. A liver enzyme test shows whether the liver is working as it should. If so, the stool will feel small or hard. A 57-year-old woman presented to the ED on January 6 with lower abdominal pain. See related content: Evaluation of Acute Abdominal Pain in Adults. All rights reserved. I have been for all the tests MRI, CT, HIDA, endoscopdy, colonoscopy, ultrasound, blood works etc etc and they have all come back clear yet the pain is getting worse as the year as went on and still going. Computed tomography (CT) has not been widely studied for the evaluation of right upper quadrant pain.14 It may be considered in patients with inconclusive ultrasonography or cholescintigraphy results or to help guide surgical planning6 (Figure 1B). i have similar symptoms too. PO Box 601504 Some things are very hard to diagnosis, so maybe you can something for pain, since most docs won't prescribe anything that's going to help. Interested in more discussions like this? and Privacy Policy and steps will be taken to remove posts identified You'll need to have every communication you make about the case available to turn over to the opposing attorney. In the interest of decreasing radiation exposure, efforts have been made to use CT more judiciously. Pain that improves after ketorolac does not necessarily indicate a musculoskeletal etiology. Your doctor will start with a physical exam. All Rights Reserved. The Celexa should start working in the next couple of weeks or so. I had a ct scan done yesterday and the results are back already that show absolutely nothing except a slightly enlarged liver (which I have been told before) Since the episode and honestly a few days prior, I have been having stomach cramping/back pain. I hope today is a better day for you. The ACR Appropriateness Criteria for abdominal imaging are based primarily on the location of pain. So there is a latest. It ruins my day to day life. She had a perforated duodenum with pain in the RLQ. Anyone else suffer from any of these symptoms and had a diagnosis, I'm having very similar symptoms. not moderated or reviewed by doctors and so you should not rely on opinions or advice given by other users in Have had stomach pain for over a year with swelling. Help? In pain but tests are clear. Any advice??? - Patient By Jennifer Whitlock, RN, MSN, FN This exam is also used to check the prostate gland, which is located at the base of the penis between the rectum and the bladder. 4. Hey Sue, I feel your pain!! I was told to go home and eat better. Have you had many abdominal surgeries? Imaging tests can also help doctors spot abnormalities in your abdomen. CT also provides more consistent results than ultrasonography,5 because ultrasonography is a highly operator-dependent technique that varies based on the skill and experience level of the technologist and radiologist. . You would have to have a scan to detect it. 2023 Dotdash Media, Inc. All rights reserved. If the pain advances to the point that standard, over the counter medications, are ineffective, we hope the patient will seek urgent re-evaluation at their nearest ED. All the doctors are trying to blame it all on my IBS, which I have had since I was 18, but I have never had any pains like this in the 10 years that I have had and not had any bad episodes with it in years as I have learned to manage it. Verywell Health's content is for informational and educational purposes only. Registered in England and Wales. The hospital ordered a CT scan for the next day which again showed nothing and everything was fine. Ultrasonography is the initial imaging study of choice for evaluating patients with acute right upper quadrant pain. If a patients symptoms are suggestive of inflammatory bowel disease, for example, we may provide a referral to a gastroenterologist, who can perform a colonoscopy for evaluation. Abdominal pain is a common presentation in the ambulatory setting, accounting for 1.5% of all office-based visits and 8% of all emergency department visits in the United States in 2010.1 Acute abdominal pain has many potential underlying causes, ranging from benign, self-limited conditions to life-threatening surgical emergencies. as well as Vicodin from a prior prescription. I wonder if simple documentation stating that the patient was told to avoid aspirin, take a PPI and follow up with GI would have been enough to save this attending from a lawsuit, regardless of whether or not the duodenum perforates. I am going to look up that disorder and definitely start keeping a food journal. Abnormalities in the pelvis can give rise to pain in the lower abdomen, or sometimes a process from the abdomen continues into the pelvis. If the patient has a bad outcome, it is preferable to have a vague but not incorrect diagnosis, rather than a specific and wrong diagnosis. Some of the more common causes of abdominal pain I see are bowel obstructions, appendicitis, diverticulitis, and kidney stones. Now i've been on Omeprazole for 4 days and my symtpoms havent gotten better. Three-dimensional models of the belly area can be made by stacking the slices together. Just a couple quick . Abdominal CT scans: Definition, uses, picture, and more Doctors dismissed her stomach pain for 6 years. Then, a CT scan changed Lab Tests. The American College of Obstetricians and Gynecologists. The CT suggested "abnormal densities in the pancreatic head". Unfortunately, I", "Hey Sue, I feel your pain!! Some pieces of advice: always talk to the lawyer hiring you on the phone. Appendicitis is a good example of a condition that can sometimes require re-evaluation . Exam of the Abdomen. If you have, you may". A 57-year-old woman presented to the ED on January 6 with lower abdominal pain. A healthcare provider inserts a lighted endoscope with a camera into the mouth. I have noticed the pain in the left side stops after a bowel movement but flares up again within an hour or so. It is more common in older individuals. Doctor's Assistant: The Neurologist can help. Traffic on JustAnswer rose 14 percent.and had nearly 400,000 page . For most locations, the ACR provides several clinical variants (e.g., presence or absence of fever, leukocytosis, pregnancy) and outlines the appropriate imaging for each scenario. Additionally, if there is no clear diagnosis for a patients pain, we do not want them to stay at home with worsening symptoms, relying on strong pain medication to avoid a repeat visit. The test uses sound waves to create images of the inside of the human body. I just discovered if I push intensely between my back ribs, that I have somewhat relief from the pain. Undiagnosed Abdominal Pain EXTREME abdominal pain. Any advise would be helpful. Testing in the ED typically begins with lab work: we check blood counts, electrolytes, kidney function, liver function, and perform an analysis of the urine. Preliminary data on the use of MRI for the evaluation of diverticulitis suggest that it may be useful, with sensitivity of 86% to 94% and specificity of 88% to 92%.8, Although certain disease processes such as cholecystitis, appendicitis, and diverticulitis commonly present with pain localized to a specific quadrant of the abdomen, diffuse abdominal pain is also a common clinical presentation. i suffer with really bad health anxiety but my GP isnt interested in my symptoms anymore and said only lifestyle changes will help. I keep having stomach aches but my doctor found nothing wrong - Zocdoc My own tumour was missed on a CT scan. 2 days later she returned again with abdominal pain. And that is not in the "normal" range for eGFR it is not terrible. So very sorry for what you're going through. on 9/18/09 2:10 pm. This content is owned by the AAFP. Raewynne . Abdominal persistent pain. Abdominal Pain: When Should I See a Healthcare Provider? Cause of a fever. i have just had a Gastroscopy which showed nothing either. The docs gave me Ranitidine to take 300mg evry night before bed and they said if that doesnt help then ive to get a camera indown my throat :s. At one point the docs asked me if it could all be in my mind???? Ultrasonography is the initial imaging test of choice for patients presenting with right upper quadrant pain. Abdominal persistent pain. Have had hida scan, CT scan, I had an endoscopy and a colonoscopy yesterday and both came back fine. I think anxiety hasnt helped my symptoms either i was constantly googling my symptoms and it was coming back with the worst results possible, but thankfully all my scans have been clear. Sometimes I may be constipated and sometimes i have diarrhea. What to Expect From a Transrectal Ultrasound, Types of Colitis: Everything You Should Know. The initial visit for abdominal pain may have had nothing to do with the duodenal ulcer that caused the perforation. Every ED clinician hopes to be able to diagnose and treat the cause of a patients pain, providing immediate relief and a resolution to the patients discomfort. This test gives us a detailed picture of all the organs from the lower part of the chest to the hips and allows us to efficiently diagnose the conditions requiring immediate treatment. For five years. For example, a patient who has been drinking heavily for decades will be more likely to have a liver problem. Like you", "Carol poses an interesting question. People with kidney conditions may not do well with contrasts. You'll have anesthesia and will be sedated throughout the exam. Some of the questions may seem personal. In all cases, an experienced physician will be needed to combine all the known information, including CT scan of the abdomen to reach a final diagnosis. ), my suggestion to vist histolic ordietition doctor if. The peritoneum gets infected by bacteria, fungi, or other irritants, leading to a painful and life-threatening condition known as peritonitis. I hope your daughter continues to feel better. Its severity ranges from annoying to life-threatening. 22 year old female with abdominal pain one week ago. We want the forums to be a useful resource for our users but it is important to remember that the forums are This includes life-threatening infections, bowel obstructions, abnormal fluid or bleeding, kidney stones, masses or tumors, abnormalities of the blood vessels that run through the abdomen, the list goes on. Normal tests but still have upper abdominal pain? - Patient Doctors may use an abdominal CT scan to look for signs of injury, infection . This test requires anesthesia so that you can sleep through it. The excessive use of aspirin was the clear red flag in this case. not moderated or reviewed by doctors and so you should not rely on opinions or advice given by other users in Upgrade to Patient Pro Medical Professional? Nothing picked up on the CT or PET. Abdominal CT Scan with Contrast: Purpose, Risks, and More - Healthline Your clinician may speak to you about the possibility of early appendicitis. Crippling stomach painand dismissive doctors Bland's stomach pain began in 2012, two years after the birth of her first child. University of California San Diego. Sometimes these scans involve the use of special dyes called contrasts. Mendelson R. Diagnostic tests: Imaging for chronic abdominal pain in adults. The doctor diagnosed her with an abdominal wall muscle strain, which was clearly incorrect. It also shows your small intestinal and the numerous blood vessels. Diagnosis of viral gastroenteritis. remar If having a CT scan would put your mind at ease then you probably should have it done. hi i wondered how you both were? over a year ago, healthnfitnessguy112567 Its more painful to sit and im dealing with constipation as well. I hope you find some relief from your symptoms. Jennifer Whitlock, RN, MSN, FNP-C, is a board-certified family nurse practitioner. An approach to narrowing the differential diagnosis based on history, physical examination, and laboratory testing, in addition to imaging, is outlined in our previous article on this topic.2 If a likely diagnosis is apparent based on the clinical presentation, imaging may or may not be indicated (Table 1312 ). An MRI isn't safe for people with certain types of metal in their body. What Are Possible Reasons For Unexplained Stomach Pain? Computed tomography (CT scan or CAT scan) is a noninvasive diagnostic imaging procedure that uses a combination of X-rays and computer technology to produce horizontal, or axial, images (often called slices) of the body. Diabetic patient given dextrose, develops compartment syndrome of the forearm. They will also look for obvious blood or growths in the rectum. If you are of childbearing years and you have abdominal pain, a pregnancy test might be a good starting place. She was prescribed Zofran, referred to GI, and discharged. The CT is often done after giving contrast through the vein and after you drink oral contrast. Magnetic resonance imaging is another emerging technique for the evaluation of abdominal pain that avoids ionizing radiation. Wrong: Ct scanning of the abdomen and pelvis shows the colon, yes, but not subtle mucosal lesions such as early cancer . Please read the disclaimer Acute appendicitis is an inflammation of the appendix. Before ordering diagnostic imaging in premenopausal women, it is important to consider obtaining a beta human chorionic gonadotropin (-hCG) measurement to narrow the differential diagnosis and to limit the possibility of exposing an embryo or fetus to ionizing radiation. Does anyone have any insight? I have pain on both my sides in my upper abdomen but its worse on the right side. Higher levels may be a sign of an infection or inflammation in the pancreas called pancreatitis. The first hyda scan showed something . At this point, will have to wait to retest CEA and if it's still elevated, CRC surgeon suggests exploratory surgery of my abdomen to see if he can see something the scans are not picking up. Treated for H Pylori and then told that was not the issue. Acute cholecystitis is a primary diagnostic consideration in patients presenting with new-onset right upper quadrant pain. Not trying to be negative Nelly here,. Evaluation of Acute Abdominal Pain in Adults. If you have to go to an emergency room. Chronic Abdominal Pain. She has experience in primary care and hospital medicine. If the patient history, physical examination, and laboratory testing do not identify an underlying cause of pain and if serious pathology remains a clinical concern, diagnostic imaging is indicated. Have you had many abdominal surgeries? Can you ask gps to explain about chronic gall bladder and symptoms that can cause. But Im in pain .Its depressing like know one will listen.. Registerer for Mayo I am It could be a while before getting in.. The first time they did a ct sacan and found nothing. Diverticulitis is often diagnosed clinically without radiologic examination, but imaging should be considered if the diagnosis is unclear or if complications (e.g., abscess, fistula, obstruction, perforation) are suspected (Figure 3). For the past year now I have been having really bad pains in the upper middle and right hand side of my abdomin like someone is stabbing me. Any use of this site constitutes your agreement to the Terms of Use and Privacy Policy and Conditions of Use linked below. While this can sometimes be the only testing that is required to make a diagnosis or rule out an emergency, we typically also consider obtaining a CT scan of the abdomen and pelvis. As mentioned, some diagnoses cannot be made initially, but the evolution of the underlying condition and the resultant development of new symptoms requires re-evaluation. One way to diagnose a health problem is to analyze substances in your body. over a year ago, pasty organisation I have started getting constipated and looser stools as well. The excessive use of aspirin was the clear red flag in this case. test of sensitivity or allergy for all types of foods your dietition doctor know it. It is also worth mentioning that it is common for psychological stress to manifest in real, severe, and debilitating abdominal pain. By Guest | 3 posts, last post 11 months ago Irfan Tariq, MD answered this Some Conditions Can Cause Severe Abdominal Pain Read more New Reply Follow New Topic Guest over a year ago I have been to the ER twice now. Patients often ask about a prescription medication when going home with ongoing symptoms. A study of low-dose CT compared with standard-dose CT found no significant difference in the negative appendectomy rate between the two groups, and the median radiation dose of the low-dose protocol was 22% of the standard-dose protocol.24 MRI is an emerging modality in the evaluation of suspected appendicitis, showing excellent sensitivity and specificity (97% and 95%, respectively) in a meta-analysis of eight studies.5 MRI avoids radiation exposure altogether, but its high cost and lack of widespread availability continue to limit its use. What tests should be done if CT scans and blood work are not showing anything except white blood cell count going up? Abdominal pain can be caused by many abnormalities, some of which can be diagnosed on CT. Have pain in right side. Feels like lump but nothing shows Any help would be awesome. National Institutes of Diabetes, Digestive, and Kidney Diseases. The pain is often severe right from the start. The ED physician ordered labs and IM ketorolac. CT of abdomen and pelvis with contrast media, Consider CT if ultrasonography is nondiagnostic, presentation is atypical, or patient is critically ill, Cholescintigraphy or CT may be considered if ultrasonography is equivocal, Choice of examination depends on institutional preferences and resources, Patients with typical symptoms and no suspected complications may not require imaging, Ultrasonography of pelvis (transvaginal and transabdominal), CT angiography of abdomen with contrast media, Conventional angiography is invasive but may be considered to diagnose and treat with a single procedure, CT of abdomen and pelvis without contrast media, Ultrasonography may be considered if CT is unavailable; ultrasonography may help detect obstruction but has poor sensitivity for visualizing stones, Conventional radiography may be appropriate for initial evaluation, MRI of abdomen without and with contrast media, See statement regarding contrast media under anticipated exceptions, Based on ultrasound findings, this generally should follow ultrasonography of the right upper quadrant, CT of abdomen without and with contrast media, Oral or rectal contrast media may not be needed depending on institutional preference, Use of oral or rectal contrast media depends on institutional preference, Perform this procedure with graded compression, This procedure is appropriate in women with pelvic pain, MRI of abdomen and pelvis without and with contrast media, See statement regarding contrast media under anticipated exceptions (, This procedure may be useful when there is concern for perforation and free air, CT of abdomen and pelvis without and with contrast media, MRI of abdomen and pelvis without contrast media, Technetium 99m white blood cell scan of abdomen and pelvis, For the procedure, oral and/or colonic contrast may be helpful for bowel luminal visualization, Ultrasonography of abdomen, transabdominal graded compression, Radiography of upper gastrointestinal series with small bowel follow-through, May be helpful in select cases but should be used with caution because of increased radiation dose, Indium 111 white blood cell scan of abdomen and pelvis, Only after other studies without ionizing radiation have been used, Because it is unclear how gadolinium-based contrast agents will affect the fetus, these agents should be administered with extreme caution, Gadolinium-based contrast agents are recommended for use during pregnancy only when there are no alternatives and benefit outweighs risk.