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Having severe stomach pain. Ultrasound and CT scan showed clear. Looking for proper diagnosis

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Answered by

Dermatologist
Practicing since : 2005
Answered : 474 Questions
Question
I am XXXXXXXfrom Chennai / INDIA.I am 36 years old.I wanted to take an opinion from you that is why i am sending you this mail.
I will give you a brief outline about my problem.....
I had severe pain in the left side of my stomach. I also vomited 3 to 4 time
during the pain.The pain started when i was learning how to swim.
The family doctor thought it is a stone related problem, he put me a voveron
injection and told me to get an Ultra Sound and Xray done the next day. The
test were clear no sign of any stone.The pain lasted about 4hrs and 15Mins.
I got the second episode again after 3 days at 5.00am in the morning.It
lasted till 1.30pm.
I again did Ultra sound and X XXXXXXX but again everything was clear.My CO-Brother also a doctor in london suggested i take an CT Abdomen Angio.The result showed clots in the spleen and liver.
I was admitted in a hospital in chennai.
The problem at hand is that,i am on blood thinners' for the past 75days and
I got another CT Scan done where the findings show no change at all.
I am deeply depressed and i am at my wits end.
I would be greatfull if you could have a look in my case and suggest me on
the course of action.
The doctors are having a doubt is it definitely dissection or is it embolic
or infection or atherosclerosis or vasculitis? if not definite, then what
can we do to confirm the diagnosis?
I would be very happy if you could spare some time and give me your advice.
My mail id is YYYY@YYYY

Regards
Posted Thu, 30 Aug 2012 in Abdominal Pain
 
 
Answered by Dr. Pravin Banodkar 1 hour later
Hello     
Welcome and thanks for your question
I would be pleased to help you with your Question

Since you have had episodes of abdominal pain and vomiting , and your reports suggest some vascular involvement Vasculitis seems to be the primary problem which may be auto immune related.
It would be important to do a series of blood tests which include XXXXXXX , ds DNA , RF , Anti histone antibodies , Scl antibodies.
These will give us a hint and remove the idea of autoimmune disorder and decision for you to be on Corticosteroids or Non steroidal medications .
The need to continue the blood thinners would be necessary and stent placement surgery would be also need to be thought of

Thanks and take care
Above answer was peer-reviewed by
 
Follow-up: Having severe stomach pain. Ultrasound and CT scan showed clear. Looking for proper diagnosis 31 minutes later
Hi Doctor,
Thanks for the reply.
I have got a series of test done and the results are negative.
The test details are given below so that you could tell me if i have missed out on any test.
1)Ana 2)ANCA 3)Lupus 4)Protein C 5)Protein S 6)ACA 7)ESR 8)LFT
9)PCNA 10)Factor V Mutation 11)PCNA .

The problem at hand is, what is the diagnosis? is it definitely dissection or is it embolic or infection or atherosclerosis or vasculitis? if not definite, then what can we do to confirm the diagnosis?

I can send you my entire file thru courier if the need arises.



Please advice
 
 
Answered by Dr. Pravin Banodkar 3 minutes later
Thanks for the reply
If the tests done are negative , it is definitely Not any vasculitis induced.
From your reports it definitely looks atherosclerotic or anatomical stenosis. Dissection is also a secondary to the stenosis detected on the scans.

The only method of confirming the diagnosis is to repeat the doppler study / scan.
No other study will reveal the diagnosis.
Thanks and take care
Above answer was peer-reviewed by
 
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