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After Gallbladder Surgery, HIDA Report Showed Low Ejection Fraction, Endoscopy Showed Inflamation. Possible Pancreatitis?

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Posted on Wed, 13 Jun 2012
Question: left sided pain and nausea

I am asking this because I am almost three months post gallbladder surgery and still have digestive issues. I had my gallbladder out on aug.5th after a HIDA scan showed a low ejection fraction of 29...it was determined I had no stones after an abdominal ultrasound, an abdominal CT scan, a small bowel study, an endoscopy, an MRI of the thoracic spine, a colonoscopy, x-rays of the ribs, neck and shoulder on left, complete blood work both before and after surgery---the endoscope showed some inflammation (thus gastritisI guess) but every thing else was normal...I take protonix (20mg) once a day, Carafate (2xday), digestive plant enzymes (with lunch and dinner),probiotics and xanax to sleep at nigh (.25mg.)--I also have pain in my left upper abdomen under ribs sometimes but it isn't bad pain (it was bad before my surgery sometimes)and I have had pain under my left shoulder blade too.....however I have had these pains on and off for 5 years but with no gastric symptoms...My presenting symptom with the gallbladder was constant nausea---and the nausea still happens on many day, especially in the morning with some reflux in my throat....My doctor doesn't seem to think I have pancreatitis because he feels it would have shown up in my tests but what could this be? What do you think---my gastro doctor thinks something would have shown up if it was pancreatitis---i am scared, queasy sometimes and don't know what else it could be---could gastritis and bile reflux be causing the nausea? Can someone have pancreatitis for 5 years without a diagnosis? Three years ago when i had bad pain, my internist did blood work and a Ct of the abdomen and nothing showed then either---although I never had gastro symptoms(nausea and diahrrea until right before the gallbladder surgery) With the testing i have had, would they have found pancreatitis or pancreatic cancer?
doctor
Answered by Dr. Poorna Chandra K.S (15 hours later)
Hi and thanks for the query
By your description i understand that the gallbladder surgery was done for gallbladder hypomotility without obvious signs of gallbladder inflammation. Gallbladder dysmotility is one of the causes of postprandial nausea and (R) upper quadrant pain.
To me the (L) upper quadrant pain and nausea seems more to be associated with your reflux/ gastritis problem given your endoscopy findings. Hence it persists even after Gall bladder surgery
Pancreatitis causing pain for 5 years would be a chronic pancreatitis which is easily picked up on CT abdomen. as it is normal the chance of pancreatitis is very very remote.
Consult your GI and get appropriate treatment for the reflux disease including a prokinetic. Get yourself a trainer to teach you some diaphragmatic exersises as a well toned diaphragm is the most powerful antireflux mechanism in the human body
Hope I have answered your query. If you have any follow up queries I will be available to answer them.
Regards
Dr XXXXXXX
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Above answer was peer-reviewed by : Dr. Raju A.T
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Answered by
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Dr. Poorna Chandra K.S

Gastroenterologist

Practicing since :2000

Answered : 339 Questions

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After Gallbladder Surgery, HIDA Report Showed Low Ejection Fraction, Endoscopy Showed Inflamation. Possible Pancreatitis?

Hi and thanks for the query
By your description i understand that the gallbladder surgery was done for gallbladder hypomotility without obvious signs of gallbladder inflammation. Gallbladder dysmotility is one of the causes of postprandial nausea and (R) upper quadrant pain.
To me the (L) upper quadrant pain and nausea seems more to be associated with your reflux/ gastritis problem given your endoscopy findings. Hence it persists even after Gall bladder surgery
Pancreatitis causing pain for 5 years would be a chronic pancreatitis which is easily picked up on CT abdomen. as it is normal the chance of pancreatitis is very very remote.
Consult your GI and get appropriate treatment for the reflux disease including a prokinetic. Get yourself a trainer to teach you some diaphragmatic exersises as a well toned diaphragm is the most powerful antireflux mechanism in the human body
Hope I have answered your query. If you have any follow up queries I will be available to answer them.
Regards
Dr XXXXXXX