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Have pain in RUQ after meals, swelling below rib cage, chest pain. Reason?

Jan 2013
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Answered by

Internal Medicine Specialist
Practicing since : 2003
Answered : 1658 Questions
Hii, I have a pain in my RUQ, after 15-20 minutes after every meal. There's a small swelling also, just below the right rib cage in the upper right abdomen area. Earlier it wasn't this severe. But day by day, the pain is increasing and i'm having Chest pain also simultaneously nowadays. I'm a male, 26 yrs old. What would be the reason?....Which specialist should I consult with??...
Posted Fri, 21 Sep 2012 in Digestion and Bowels
Answered by Dr. Mayank Bhargava 32 minutes later
Thanks for posting your query.
Do you have fever/ vomiting/ yellow discoloration of sclera & urine?
You are most like from cholecystitis.
In RUQ, following organs are present: liver, gall bladder, hepatic flexure of large intestine, 2nd part of duodenum, part of right kidney.
Pain increasing after eating occurs only in three conditions: acute or chronic cholecystitis, acute or chronic pancreatitis and peptic ulcer disease.
Presence of pain in RUQ and increasing after meal, palpable mass in RUQ (in chronic cholecystitis, gall bladder walls are fibrosed due to recurrent and persisting inflammation) suggest acute/ chronic cholecystitis.
Have you undergone ultrasound imaging? What was its report?
Cholecystitis may occur due to presence of gall stones (obstructing cystic duct of gall bladder) and in absence of gall stones (called as acalculous cholecystitis).
Acalculous cholecystitis generally occurs in old age, bed ridden , on total parenteral therapy patient. So considering your young age, possibility of acalculous cholecystitis is least likely.
You should consult with physician/ gastro-physician and should go for following investigations: complete blood count, liver function test, ultrasound imaging, CT/ MRI if needed.
Although your history suggest cholecystitis but if ultrasound imaging is normal (means gall bladder is normal without stones), then you should go for following investigations: UGI endoscopy (for peptic ulcer disease), colonoscopy (for hepatic flexure pathology), urine examination for renal stones.
I have answered almost all queries.
Put your views if any one, It will be my great pleasure.
Best regards,
Dr. Mayank Bhargava
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