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Dr. Andrew Rynne
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Dr. Andrew Rynne

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What causes severe lower abdominal pain and elevated WBC count?

Answered by
Dr.
Dr. Mukund Savaskar

General Surgeon

Practicing since :1978

Answered : 3607 Questions

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Posted on Thu, 1 Oct 2015 in Abdominal Pain
Question: I had severe lower abdomen pain and was rushed to hospital and was given a voveran injection for relief. I was prescribed usg which was normal, an xray(kub) which was normal, blood test was ok except for high level of wbc count (15030) (Normal range-4000 to 10000). Neutrophilic leucocytosis was seen. Lipase and amylase were normal. Blood urea and serum creatinin was within normal levels. Urine routine examination revealed calcium oxylate in the range of 10-15/ lpf and epithelial cells 10-15/ hpf. No cast or crystals were seen. Urine culture reports are awaited. Does this means i have stones in my kidney or is it an infection? What should i do?
doctor
Answered by Dr. Mukund Savaskar 47 minutes later
Brief Answer:
Acute Lower Abdominal Pain?Under Investigation.

Detailed Answer:
Provisional Impression-Acute Lower Abdominal Pain?Under Investigation.
HI,Thanks for your query to HCM Virtual Clinic.
My pleasure to give Second Opinion on your Acute Abdomen?under Investigation.
Based on the facts of your query data and review of the latest Blood reports and USG reports,I would need more information,as the data is insufficient to point towards stones in Kidney or Renal Infection.
Please don't jump to any conclusion from the urine and blood reports,as the clinical picture is not clear still in last 24 hours.

Please send More information as follows-
On which side of the lower abdomen was the pain started and located?
How it started? was it related to any jolt/ sudden increase in abdominal pressure?
When was your last menses date?
Any problem with your menses?
How many kids you had? Any problem with your obstetric history?
Was there any back/lower down genital part referral of pain?
Was there any nausea/vomiting?Any outside fooding in last 48 hours?
How was the stools in last 3 -4 days time?
Were you normal before this acute lower abdominal pain?
Any medications you take for any other illnesses in the past/in the presence?
Any self medication of drugs / like painkillers ? and since How long?
Any such pain in the past in upper right or left abdomen?
What is your job work/ life style?
Is the pain related any how to your food intake yesterday?
Update any past medical reports/doctor's notes?

Awaiting your updates on more information as above.
Waiting for any further updates in regard to this query?

Dr.Savaskar M.N. XXXXXXX Surgical Specialist,
M.S.CVTS.
Above answer was peer-reviewed by : Dr. Prasad
doctor
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Follow up: Dr. Mukund Savaskar 21 hours later
On which side of the lower abdomen was the pain started and located?
It started at Left lower abdomen and then radiated out towards right abdomen and then traveled downwards.
How it started? was it related to any jolt/ sudden increase in abdominal pressure?
I was on my 6th day of menstrual cycle. But normally I do not have cramps during my cycles. I was not comfortable since morning. But it was not like typical menstrual cycle pain. My limbs had become numb at the time of pain.
When was your last menses date?
It started on 6th of Sept, almost 6 days earlier than my actual cycle date.
Any problem with your menses?
No problem -as such as i have one months cycle by 30 days and the other by 20 days and this time it was on the 20th day.
How many kids you had? Any problem with your obstetric history?
No kids as of now. No such history, but i had taken 6 injections of Menotas 150 from D3 to D8 in my last cycle dated 17th August( the injections were taken from 20th Aug- 24th August) as suggested by my Gynecologist for conception.
Was there any back/lower down genital part referral of pain?
There was no back pain
Was there any nausea/vomiting?Any outside fooding in last 48 hours?
There was no nausea or vomiting. My work needs me to travel hence i was out the day before and had taken bread, omlet, rice, curd and noodles (just boiled with no masala only carrots)
How was the stools in last 3 -4 days time?
No problem- it was completely ok
Were you normal before this acute lower abdominal pain?
Past few days i was feeling a faint pain after discharge of urine. I thought it could be because I wasnt consuming enough water . Since the discomfort was very faint i ignored it
Any medications you take for any other illnesses in the past/in the presence?
I take folvite, fertisureF, all9, dufaston and lumia60k as suggested by my Gynocologist apart from Menotas 150 injections
Any self medication of drugs / like painkillers ? and since How long?
Only occasional ranitidine I take on need basis.
Any such pain in the past in upper right or left abdomen?
2.5 yrs back i had similar pain during my menes cycle and was detected with appendicitis. That time i had under gone appendix operation.
What is your job work/ life style?
My job requires me to travel 6 to 7 days in a month but it is not continuous. Rest of the month i am in my office for 9 hours, desk job.
Is the pain related any how to your food intake yesterday?
No it was not.
Update any past medical reports/doctor's notes?
Only appendix and earlier i used to have gastric troubles but it is not there for many months and i do not have any kind of bowels or gastric trouble now.
doctor
Answered by Dr. Mukund Savaskar 7 hours later
Brief Answer:
Acute Lower Abdominal Pain ?Menotas Induced Ovarian Cyst Rupture.

Detailed Answer:
Impression-Acute Lower Abdominal Pain ?Menotas Induced Ovarian Cyst Rupture.

HI,Thanks for the updates.

1-Ans-to Could it be Kidney stones ?Infection?
-Wait till Urine Culture report comes,to rule out UTI/or kidney infection,which is a remote possibility in the current scenario.
-Based on the updates and the facts of the query,You don't seem to have kidney stones or kidney infection as a cause of this acute lower abdominal pain in your case.
-Your clinical picture is now clear,which suggests that the cause of the acute lower abdominal pain mostly seems to be ?Ovarian Cyst rupture,even while you were on 6 th day of menses.
This could happen due to the Menotas therapy which you are taking with other fertility medicines,where in multiple Follicular cysts grow up and incidentally one of it has ruptured.
The acute pain during the menses, with numbness in the limbs on the day of acute abdomen, was due to the acute shock from ?ovarian cyst rupture.

2-Ans to -What should You do?
Co-operate with the hospital doctor team there, for you to recover fast.
Consult your Treating Gynecologist.
-So don't worry for any kidney stones.
Report me about the Urine Culture report.
Call me if you need some help from my side.
-For to work up other causes,I would therefore suggest to contact your treating Gynecologist.
I would Suggest to consult your Gynecologist for further treatment in this regard.

Hope this reply has resolved your query issue satisfactorily as I answered both your issue with this query.
Also this reply would help you to plan further treatment with your hospital doctors and your Gynecologist doctor.

Will appreciate hitting thanks and writing excellent review comments,in the interest of the visiting needy patients like you, at HCM.

Welcome for any further query in this regard if need be and I would love to attend to it.

Good Day!!

Dr.Savaskar M.N. XXXXXXX Surgical Specialist,
M.S.CVTS.
Above answer was peer-reviewed by : Dr. Neel Kudchadkar
doctor
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Follow up: Dr. Mukund Savaskar 25 hours later
Dear Doctor, My urine culture report has come today. It states ' no uropathogenic bacteria grown in culture after 72 hrs of incubation.' So does this means i am safe from kidney stones and uti completely? So now i need to consult my gyni?
doctor
Answered by Dr. Mukund Savaskar 6 hours later
Brief Answer:
Acute Lower Abdominal Pain ?with Ovarian Cyst Rupture

Detailed Answer:
Provisional Impression-after Updates-
Acute Lower Abdominal Pain ?with Ovarian Cyst Rupture

Hi,Thanks for the updates on Urine Culture.
Hope you are recovering from your acute Lower Abdominal Pain.
Reviewed your Urine Culture report.
Yes,You are absolutely free from risks of Kidney stones and UTI.
Now you can have Second Opinion from your earlier Gynec Doctor in XXXXXXX with whom you are taking fertility treatment for conception.

Hope this reply has helped you to come out of the worries and acute anxiety of this Acute Lower abdominal pain.

Hope this satisfies your need.

Will appreciate your writing excellent review comments,to help visiting needy patients like you, at HCM.

Welcome for any further query in this regard if need be and I would love to attend to it.

Keep me updated on further health progress.Do contact by Premium direct question to me,if needed.

Wishing you early painless conception in time to come.

Good Day!!

Dr.Savaskar M.N. XXXXXXX Surgical Specialist,
M.S.CVTS.
Above answer was peer-reviewed by : Dr. Neel Kudchadkar
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