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What Causes Pain In The Upper Right Abdomen While Having A Parastomal Hernia?

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Posted on Tue, 12 Jul 2016
Question: I have been having gritty XXXXXXX stools and losts of pain near my liver and small intestine. the pain is verysharp and I feel it deep inside me. i curently have a peristomal hernia. I have had two in the past 3 years both have been repaired now I am on my third one. I am obease about 60 lbs over weight and i am losing 3-5 pounds every two days. I cannot eat or drink much due to the pain. ER personnel and primary care doctor say everything is ok except for what I mentioned.
doctor
Answered by Dr. T Chandrakant (1 hour later)
Brief Answer:
Investigations and consultation of a Surgeon.

Detailed Answer:
Hi.
Nice to see you after July 2014.
Thanks for your query.
To recapitulate: Female/55 - have gritty XXXXXXX stools - sharp and deep pain near liver and small intestine - currently have peri-stomal hernia - 2 repaired in past 3 years - obesity - 60 lbs overweight - loosing 3-5 pounds every 2 days - can not eat or drink due to pain - consulted ER and PCP ....

My thoughts:
Considering the history of ileostomy, 2 previous surgery and peri-stomal hernia, your symptoms are most suggestive of intestinal obstruction, as you can not eat or drink due to pain and loosing weight.
I would advise you the following in such a situation.
- X-ray of the abdomen in standing position can show gas-fluid level, so classical of obstruction.
Ultrasonography and CT scan of the abdomen can add to the diagnosis accuracy and can also detect if there are any other problems.
Clinical evaluation and examination has still an important space in diagnosis and one can hear on auscultation typical sounds.

Getting a correct diagnosis is most important as then only can be a proper plan of treatment.

I hope this answer helps you to get a proper diagnosis at the earliest. Please discuss with your Doctors or best is to get a referral.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. T Chandrakant (1 hour later)
In early XXXXXXX this year and March of this year x-rays pointed to no obstruction. Ihad a CAT scan done and an endosopy of my small intestine. Only showed a small bit of gasteritus along with the hernia and fatty liver. Blood tests the liver tend to go very high. I'm not sure what to do next since all seem normal with exception of the x-ray in XXXXXXX which showed that I was constipated. I am wondering why they did not do a CAT scan in this case to better show a possible obsruction or something else. I asked but they refused. I have an appointment with the Clevand clinic in late July. I hope I don't have any emergencie before then. I am seeing 1 gastro, 1 liver specialist and a , a colol rectal sergeon at the clinic. Perhaps they will take a more serious approach to my issues. thank you XXXX
doctor
Answered by Dr. T Chandrakant (44 minutes later)
Brief Answer:
As discussed.

Detailed Answer:
Thanks for your feedback.
If the liver functions are showing high values, particularly the GGT and or Alkaline Phosphatase there possibility of partial obstruction of biliary system. You may please the reposts.
In such a situation an ultrasound, CT scan or MRCP can add on the diagnosis.
Till you go to the higher centers get standing X- ray of abdomen when there is an actual pain.
Insist for CT and or MRCP. If done well and good.
Be on liquid diet.
Please post reports if available.
Note: For further follow up on digestive issues share your reports here and Click here.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
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Dr. T Chandrakant

General Surgeon

Practicing since :1984

Answered : 19777 Questions

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What Causes Pain In The Upper Right Abdomen While Having A Parastomal Hernia?

Brief Answer: Investigations and consultation of a Surgeon. Detailed Answer: Hi. Nice to see you after July 2014. Thanks for your query. To recapitulate: Female/55 - have gritty XXXXXXX stools - sharp and deep pain near liver and small intestine - currently have peri-stomal hernia - 2 repaired in past 3 years - obesity - 60 lbs overweight - loosing 3-5 pounds every 2 days - can not eat or drink due to pain - consulted ER and PCP .... My thoughts: Considering the history of ileostomy, 2 previous surgery and peri-stomal hernia, your symptoms are most suggestive of intestinal obstruction, as you can not eat or drink due to pain and loosing weight. I would advise you the following in such a situation. - X-ray of the abdomen in standing position can show gas-fluid level, so classical of obstruction. Ultrasonography and CT scan of the abdomen can add to the diagnosis accuracy and can also detect if there are any other problems. Clinical evaluation and examination has still an important space in diagnosis and one can hear on auscultation typical sounds. Getting a correct diagnosis is most important as then only can be a proper plan of treatment. I hope this answer helps you to get a proper diagnosis at the earliest. Please discuss with your Doctors or best is to get a referral.