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Query about right upper quadrant pain in abdomen - Online Doctor Chats

Date : 21-Feb-2012
User rating for this question
Very Good Posted in: Abdominal Pain
Answered by

General & Family Physician
Practicing since : 2004
Answered : 37 Questions
Doctor :   hello
User :   Hello. I have a few questions about some testing and symptoms I have had this past week. I have been a trauma nurse for 17 years so I understand much of what's going on - but not all of it.
Doctor :   sure please go ahead
User :   I am healthy, and only surgery is a cholecystectomy (with stones) in 2004. I have had a dull and achy RUQ pain since last July off and on. Last week it became very painful and I have been nauseated.
Doctor :   ok
Doctor :   may i know your age and gender please ?
User :   My initial CT showed 3 liver lesions, then a CT that determined 2 were hemangioma's and one was FNH.
User :   Oh - I am 30 yo female
User :   39 years old - sorry
User :   GI Consult suggested an EUS, which I had yesterday, and there are no stones in my ducts
Doctor :   ok
User :   GI doc stated that the FNH and hemangioma's are incidental and that they are not painful and do not cause my symptoms.
User :   My concern is that in my research about FNH, I see they can be symptomatic. Is that correct?
Doctor :   thats correct
Doctor :   well but not always
Doctor :   well let me tell you one thing as you yourself are a medical professional
User :   ok
Doctor :   that when ever we read about a condition ... in real life the fact remains that ANYTHING CAN BE ANYTHING
User :   Yes, I agree completely.
Doctor :   so there are equal number of cases where the patient experiences no symptoms at all
User :   I'm thinking that I may need to see a liver doctor?
Doctor :   you do need to get your LFTs done
User :   oh, yes, and that's the other thing. DUring my physical last July with my PCP, my liver enzymes were elevated. We re-did the test, and they were still elevated only slightly. I blew it off. Since my pain has gotten worse, my AST, ALK PHOS, liver enzymes - everything is perfect. Picture of health on paper.
Doctor :   do you consume alcohol ?
User :   No not really. The last time I had a glass of wine was over 8 months ago, and prior to that only occasionally and not in excess. I excercise a lot and have maintained a pretty good diet.
User :   I had no alcohol prior to the LFT's in July.
Doctor :   ok
Doctor :   thats good
Doctor :   so when was the last LFT done ?
Doctor :   july right ?
Doctor :   so i think you need to repeat them
User :   last week, and then yesterday prior to the EUS my AST was a little elevated
Doctor :   also i will recommend a U/S of abdomen
User :   ok. I suppose my primary question is, is it important to follow up with the FNH, or should I just see how my symptoms are and get another CT in 3-6 months?
Doctor :   so at this moment what are your symptoms?
User :   I burp constantly, and it feels like a small fist is right behind my boob and my back on the right side behond my scapula
Doctor :   FNH is benign and it does not need really constant follow up unless you have symptoms
Doctor :   how long has it been since your last CT ?
User :   I had both of them last week
Doctor :   well then its ok
Doctor :   and your LFTs?
Doctor :   are you there >
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