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What causes pain under right rib and hig bilirubin level?

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Posted on Mon, 14 Jul 2014
Question: please help desperate for some answers the past few days i have been in and out of the hospital for pain under right rib its sharp stabbing pain and feels inflammed sometimes resting will allieviate it but not always. i had my gallbladder out 8 weeks ago but this pain really didnt intensify until about a wek ago. i have had all blood work with the only abnormality being my billirubin which in two days went from 38 to 55 this did not seem to cause alarm i had chest xray that was clear and ultra sound was clear but i was told sometimes ultra sound does not always pick up bile strictures? so they sent me home with no real answers i dont understand why a ct scan was not orderd to further investigate now i am not a doctor but high bilirubin yellowing of eyes which i do have and abdominal pain does coincide with bile stricture or narrowing but im not sure if ultra sound would show that? now i will say i do have anxiety but am on meds for that i honestly feel like they think its all in my head and its my anxiety. im still in pain eyes are still yellow and billirun is still high should this not b investigated further or is there no cause for alarm here?
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Answered by Dr. Grzegorz Stanko (35 minutes later)
Brief Answer:
Bile ducts obstruction.

Detailed Answer:
Hello!

Thank you for the query.

From your symptoms and high bilirubin level you are dealing with bile ducts obstruction due to a stone inside. This is more possible if your urine is dark and stool whitish.
CT scan is good for pancreas diagnostics, but stones can be invisible in this test. Ultrasound can sometimes miss the stone as well.
There should be liver tests done including AST, ALT, GGTP, AP. If GGTP and AP will be elevated, ERCP procedure (endoscopic method of bile ducts revision) should be done. If this will be left alone, bile ducts inflammation, liver failure or acute pancreatitis can appear.
And you should not wait with it. Please consult gastroenterologist.

Hope this will help. Feel free to ask further questions.
Regards.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Follow up: Dr. Grzegorz Stanko (2 hours later)
all my liver enzymes tests came back clear just the billirubin was high my urine is not dark and stool is not whiteish would u still suspect this ?
doctor
Answered by Dr. Grzegorz Stanko (6 hours later)
Brief Answer:
.

Detailed Answer:
Can you please attach the tests which have been done recently?
If GGTP and AP are low, bile ducts obstruction is hardly possible. But you should have some more tests to find out the reason of high bilirubin. Abdominal CT and liver viral tests should be done.

Regards
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
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Dr. Grzegorz Stanko

General Surgeon

Practicing since :2008

Answered : 5769 Questions

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What causes pain under right rib and hig bilirubin level?

Brief Answer: Bile ducts obstruction. Detailed Answer: Hello! Thank you for the query. From your symptoms and high bilirubin level you are dealing with bile ducts obstruction due to a stone inside. This is more possible if your urine is dark and stool whitish. CT scan is good for pancreas diagnostics, but stones can be invisible in this test. Ultrasound can sometimes miss the stone as well. There should be liver tests done including AST, ALT, GGTP, AP. If GGTP and AP will be elevated, ERCP procedure (endoscopic method of bile ducts revision) should be done. If this will be left alone, bile ducts inflammation, liver failure or acute pancreatitis can appear. And you should not wait with it. Please consult gastroenterologist. Hope this will help. Feel free to ask further questions. Regards.