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Having pain in abdomen. Gallbladder has been removed. Reason?

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gallbladder has been removed - have the same classic symptons of pain under rib cage. liver test slighly high
Posted Tue, 26 Feb 2013 in Liver and Gall Bladder
Answered by Dr. Grzegorz Stanko 53 minutes later

Thank you for the query.

It is very common that pain caused by peptic ulcer and gallstones is very similar. That is why, some patients after gallbladder removal do feel the same pain which supposed to be from gallstones. It is because there was not gallstones causing this pain but peptic ulcer.
Classic gallstones pain is located in the right upper abdomen and radiates to the back. Usually it appears after a fatty foods. Peptic ulcer pain usually appears after 1-2 hours of the meal, it is localized in the upper center abdomen. It does not radiate anywhere.
The other possible option of your pain are stones in the biliary tract. In such case, the pain can be very similar to the gallstones pain. It shows up in the ultrasound as obstructed bile ducts and gives elevated liver tests (especially GGTP and AP are elevated).
So it is advisable at your case to have abdominal ultrasound and GGTP, AP levels. If no findings, upper GI endoscopy should be performed.

Hope this will help.
Above answer was peer-reviewed by
Follow-up: Having pain in abdomen. Gallbladder has been removed. Reason? 1 hour later
I have had a ct scan - would the stones show up on the CT scan or not
I do not have symptom of jaundice - should this be apparent
Answered by Dr. Grzegorz Stanko 40 minutes later

CT scan wont show the stones. Only ultrasound can do that. Jaundice is not necessary. Your bile ducts can be only partially obstructed so the bile can flow freely and the pain is caused by stones. GGTP and AP will be elevated if so. Bilirubin can be normal.
Peptic ulcer is something you should also consider.

Hope this will help.
Above answer was peer-reviewed by
Follow-up: Having pain in abdomen. Gallbladder has been removed. Reason? 18 days later
I have had an Ultra sound that didn't reveal much - ectasia & dilation extra hepatic ducts CBD diam 15mm(possibly appearance may be post cholecystectomy - fatty liver...(I'm fixing that hardly eating these days)
going back to when my pain started now 6 weeks ago. it came on over a period of 3 days it was a level 7 ( in my mind ) taking pain killers constantly. would need pain killers 3 to 4 hours waking up a night in pain.
this isn't apparently typical pain experienced with stone or what ever.
as my pain was so consastant is it possible to have a stone in the bile duct that maybe moves and then disolves but still causing pain. A specialist has been recommend but the pain is now very low. So don't think it necessary
what could it be from? Petic ulcer was not considered.
Answered by Dr. Grzegorz Stanko 8 hours later

Please read carrefuly my previous answer: " if no findings, upper GI endoscopy should be performed." Like I have said before, peptic ulcer symptoms can be very often misdiagnosed and thought to be gallstones pains.
Taking pain killers you will make the ulcer worse. You should start instead Omeprasole 40 mg once a day, in the morning before the meal. Avoid coffee.
If no bile ducts dilated in the ultrasound, the stone is rather impossible. If you want to be sure, please make the tests I was asking you about (AST,ALT,GGTP and AP). This tests are very sensitive for gallstones and will be elevated if any stone is there.
But in my opinion, you do suffer from peptic ulcers.

Hope this will help. Feel free to ask further questions.
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