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I started with right upper abdominal pain about 6 months ago. It gets severe
at times, comes in waves. Two weeks ago I had an episode of severe pain, green
diarrhea, nausea, and felt horrible for two days. I figured it was my
gallbladder. I am 36, female, obese. I went to a doctor, she thought it was the
gallbladder too. I had an ultrasound which only showed mildly enlarged liver, of
course with my weight they could not get a perfect view of the gallbladder. My
liver profile was fine except for a low direct bilirubin, which I am told is
fine. Nothing else is being done. In the meantime, I still have the pain and the
enlarged liver. Do you think other studies should be done? I am starting to feel
like I am nuts and all this is a figment of my imagination. Help!
Response
You may request the HIDA scan, or hepatobiliary imaging. This scan is useful
in demonstrating an obstructed cystic duct, which is the cause of inflammation
of the gallbladder (acute cholecystitis) in most patients. This test is reliable
if the bilirubin is under 5 mg/dl. The disorders most likely to be confused with
acute cholecystitis are perforated peptic ulcer, acute pancreatitis,
appendicitis, perforated colonic carcinoma or diverticulum of the hepatic
flexure, liver abscess, hepatitis and pneumonia with pleurisy on the right side.
Your question, however, can not be answered completely without a complete
history of your problem, a thorough physical examination and a laboratory
evaluation.
We advise you to see your local physician for a referral to a board-certified
gastroenterologist or general surgeon. If you are seeking a second opinion, we
suggest that your diagnosis is confirmed by experts at an institution
experienced in identifying digestive disorders. Your local physician may be able
to make such a referral.
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