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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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What Causes Abdominal Swelling Along With Pain In Groin?

I am in no manner seeking out medical advice, per se. I just want to see what someone in the medical field has to say about what has been going on with me. I have been sick since October 2014. It all began when I was at work one evening during the first week of October, and suddenly felt a sharp, jabbing pain deep in the groin of my LRQ. My abdomen began suddenly swelling with fluid. By the following morning, I looked about 7-8 months pregnant. I sought treatment at the local ER that day. Standardized blood tests and a CT of abdomen revealed nothing. I was sent home with Simethicone, and advised to f/u with a gastro and obgyn. (I am a 51 y/o female with a history of RA and hypothyroid No drug or alcohol abuse. No diabetes, heart disease or bp issues). After a week, the swelling subsided. A routine colonoscopy a few weeks later revealed a clean and healthy colon. A routine visit to my OB showed nothing remarkable, except a polyp on my endometrial lining, that has since been removed via a D&C. About a week following the first incident with the jabbing pain in the groin of my LRQ, I then experienced a similar pain in the left groin, I am guessing in the inguinal lymph node? Don t know - not in the medical field. That night I began feeling sharp pain just outside of my left axillary region, where the lower part of the shoulder meets the upper thoracic cavity - just outside of the breast. I also noticed a slight swelling in the area, the size of a pea. I called my doctor, who told me to take a NSAID and see if it was relieved. The next morning I felt fine. But then a few days later, the pain in the left axillary area began again, and would not relent. I never experienced any significant swelling in that area - just excruciating pain down the side my mid-thoracic area. My doctor told me to come in and see him. In the beginning of November, I began running low grade fevers every day, several times a day, and did so for about five weeks - up into the second week of December. My spleen began to bother me, but never swelled up. The pain began to travel. It remained in my left axillary region for some time, and was often excruciating. It was a stinging and jabbing pain. It began to travel across the top of my chest, and sometimes I felt it was affecting my heart muscles, and a couple of times i became dizzy and a sharp pain would make me see colors and take mu breath away. A complete cardio work-up in December revealed nothing. The pain continued to travel across the top of my chest, at one point settling in my right breast, and then went over to the right side of my chest, and down below the left axillary area, again, where the lower part of the shoulder meets the outside of the axillary area. It stopped in that area, never traveled below it, and oftentimes the pain went from the right side to the left. My PCP referred me to an oncologist, and standard blood work ordered by an oncologist revealed nothing. In the interim, I was making multiple trips to emergency rooms and my primary care physician for the pain and the fevers, always to no avail. My abdomen continued to erratically bloat up significantly with fluid, ascites, whatever you want to call them. The bloating became so severe at one point, the fluid was forced down my legs one day, and up into my thoracic cavity the next day. It eventually receded. My last attack with acute ascites was on January 5, 2015. My breasts looked and felt as if I were lactating. They were heavy and painful. A visit to my ob revealed nothing breast-related. The veins were protuding from both breasts, and were blue and quite pronounced. Multiple imaging tests have continued to reveal nothing. My PCP referred me to an IDS at the end of December, who tested me for Lupus, Sarcoidosis and TB. All tests - normal. In February of this year I visited the same gastro who performed the colonoscopy, and I was jumping off of the table when he pressed on the right lower part of my abdomen. He reviewed a CT report of my chest and abdomen done in December, and said he thinks I might have some type of infection. He put me on Flagyl 500 mg bid x 14 days, and the same course of Cipro. The first week the abx were working great. I could feel the infection receding a little each day. The bloating in my abdomen went down significantly. I actually felt normal again for the first time in many months. I could function, I could get out of bed, I was happy, I was smiling. I felt as if I had been given my life back. Then after about six days, the meds stopped working. I finished the full course of both meds, ended up with oral thrush and diarrhea, and the infection, or whatever the condition is, has now slowly returned. I once again look like I am about 7-8 month pregnant, and my LRQ is still painful and tender, as are the sides of my mid-thoracic cavity and my left axillary region. I am due for a follow-up with the gastro tomorrow (Wednesday). What he will do next, I have no idea. Last night I once again stupidly went to the ER, thinking that maybe, just maybe, this time was going to be the time someone found something. Blood work and CT of abdomen - normal. Since October 2014, I have had a trans-vaginal sonogram, a sono-hysterogram and a D&C, so anything gyn-related would have turned up in one of those procedures. Biopsy of endometrial lining, and polyp pathology following D&C were both normal. Here is an odd but I hope helpful tidbit of information: Right after I began getting sick and running fevers, I also began experiencing what has been defined to me as ascending paresthesia. It only occurs at night while I am lying down in bed, and if oftentimes wakes me up. I get the feeling at different locations - up my side, up one side of my back, up my abdomen, and sometimes up my entire back. It is a strong, hot, stinging, burning tingling sensation, and I always feel that part of my body to be on fire, yet the skin is perfectly cool to the touch. I also overheat a lot when I am lying down in bed. Sometimes the paresthesia travels in small tremors all the way up into my brain, at which time I feel a temporary sense of disorientation. A few times the paresthesia woke me up with tremors going up my spine and reverbating feeling into my brain. An MRI of my brain has revealed nothing. Afterwards, I feel nauseous and dizzy, and remain that way for the entire day. This occurs every night, or almost every night that I am aware of. I am tired of drinking gingerale, and I am tired of taking Pepto Bismol and Zofran, which no longer work for me anyway. Upon advice of my PCP, I visited an ortho yesterday, who ordered an MRI of my L-spine, with and without contrast. I am due to have that test performed later this week. I just find it so odd how every single symptom, inclusive of the ascending paresthesia, which always originates from my hips and lower abdominal area, all began within the same time frame. My PCP also prescribed 30 days of Valium last month, to see if it helped with the tremors and the paresthesia, but it did not. Five months after the fact, I am still just as sick now as I was then. Numerous sets of blood tests, visits to numerous competent and reputable specialists, numerous diagnostic imaging tests, have all revealed NOTHING. My condition obviously is some type of an infection, or certainly has the properties and the symptoms of such, yet its source and origin cannot be found. Right now my left inguinal lymph node is painful but not swollen, and coincidentally, I am also experiencing pain in my left axillary region, and down my side. I am of menopausal age, since age 48. The lymph node and the axillary are painful to the touch, yet no swelling. I have not had a fever in three months - since the middle of December. I also still have pain in my left breast, but not my right one. Right now my lower back is tender to the touch, and feels like it is on fire. I am at wits end, and do not know what else to do. What is causing the ascending paresthesia, and why is it so hot, stinging and burning? I also experience occasional tingling in my head, but have not in some time, This was more prevalent in the beginning, and it occurred moreso in the day time than at night. I do not know if this is relative or if it will help, but during the first part of 2014, I lived in an area of NYC that had a large east African and Caribbean community. But I left there in the beginning of May 2014, and I did not begin to get sick until the first week of October - five months. I cannot see a parasitic infection taking that long to manifest itself and make itself known? And my PCP also said that normally a parasitic infection would cause at the very least an elevated eosonophil level, and to date all of my blood work has come back within range. I also have never experienced any type of digestive distress as far as vomiting or diarrhea (aside from the present condition brought on by elongated use of abx). My bowel movements are regular and normal-looking, and several urine cultures have come back normal. For someone who has been so ill, I find it funny how my blood is across the board perfect. I am at my wits end, I do not know what else to do anymore or who else to turn to. I am frustrated, have exhausted almost every medical resource, I am unable to function properly within mainstream society, I feel bloated and nauseous almost every single day, and am almost ready to give up hope, which is basically all I have left. Thank you in advance for any opinions anyone is willing to offer.
Thu, 19 Mar 2015
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What Causes Abdominal Swelling Along With Pain In Groin?