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What causes upper abdominal pain and vomiting after gall bladder surgery?

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Posted on Fri, 3 Mar 2017
Question: Please help with my upper abdominal pain and vomiting after babies c-section and gallbladder surgury! Its been 3 months!

Symptoms-

Extreme upper abdominal pain/pressure that radiates to my back between shoulder blades and behind my stomach after eating that causes nausea and vomiting within minutes after eating or drinking anything including water sometimes. Forced vomiting has also occurred to alleviate some pain because of how severe it is. I also have belching and high blood pressure and 1 test shows slightly elevated liver enzymes. They also found a small sliding hiatal hernia which they say is not enflamed and would not cause this.



Lab Work-

I have had several CAT Scans (approximately 4) from 2 different hospitals, a barium X-ray, 2 endoscopies from 2 separate gastrologists , an ekg, a catscan of my brain, and tons of blood work including endoscopy biopsy and everything is apparently fine besides what was mentioned in the symptoms. Before my gallbladder removal I had a hiatus scan that they said showed my gallbladder was not functioning. (This is why they chose to remove it but obviously has not fixed the issue and is currently getting worse.)

When it started-

This all started after excess vomiting during my pregnancy. I ended up being diagnosed with pre-Eclampsia that turned into helpp syndrome (Really high blood pressure, protein in urine and high liver enzymes and ended up emergency delivering a month early by c section November 22nd 2016.) Before leaving the hospital after the babies c section I ate a decent sized meal again for the first time in several weeks and ended up with what they said was a gas bubble and got sent home where my symptoms slowly got worse each day eventually causing me to go to the ER on several occasions. I eventually ended up getting my gallbladder removed 3 weeks ago after a hiatus scan and was great for 3 days on oxycodine. I have since been hospitalized 4 times where each time they did testing gave morphine for pain and never find anything in the ER. Each time they Released me without solving the issue. I am currently and finally still admitted from my gallbladder surgeon (whom I really like and I can tell he really wants to help) who got me admitted finally after begging but I am going home tomorrow after 4 days and tests at the hospital because they say there is no other tests at the time. I am scared and really want help. Morphine and oxy or any pain med for that matter is the only thing that helps once it kicks in.

Again I can be fine all day sometimes and eating anything will immediately return my symptoms while other times I can eat a few bites and feel ok and an hour later have a sip of ginger ale or ensure and feel immediate pain again. The pain is on my upper middle abdomen and middle chest and radiates directly to my back as well between my shoulder blades and behind my stomach.

Are there any other suggestions or tests? Any possible things to check for as well? Please any advice will be great! Nothing NOTHING is making this go away and it is unbearable. If I go home again I will be back in the ER within 3 days with dehydration because without IV my symptoms get worse each day to the point of extreme dehydration from vomiting and pain.

I will also state that since the 4 days in the hospital I have extremely improved but this has happened before and the second I get home I end up here again! The only reason I think I’m improving here is because the pain meds allow me to eat small portions (liquid diet) without the pain. (Without the pain meds the pain will NOT go away)

I also threw up blood that looked like coffee grounds about 3 times or so but they said its normal because of the amount of vomiting I am having. If I’m not in the hospital and it gets bad, the pain and nausea become so bad I vomit every 15 minutes and end up going to the ER from the pain and fear of dehydration.

History-

I have a history of gerd and was on nexium for a whole year (still on it)

Prescriptions-

I am currently prescribed klonapin for anxiety from all the stress, bp medicine as needed and oxy as needed for when I do try to eat or drink while in the hospital. I was recently removed from morphine which I was on again for the past 3 days and the oxy seems to be working just as well.


Extra notes-

Pre pregnancy weight is 170LBS I am now 145 LBS. (Down 72 lbs since my 217 birth weight)

No fever has ever been recorded

Current BP in the hospital is 120/90 and 110bpm heart rate

BP before I was admitted this time without the pain meds was 175/114 consistently until I got blood pressure medication.

Liver enzymes are still slightly elevated but have gone down since my 4 day stay in the hospital began.

My BP has been quite normal since then without BP medication though.

Please help!

Is it possible this is still from gallbladder surgury? It has been several weeks.
doctor
Answered by Dr. Ramadevi Wani (1 hour later)
Brief Answer:
Get an ERCP ( endoscopic retrograde cholangio-Pancreatography) done

Detailed Answer:
Hi,
Welcome to Healthcare Magic.
I am Dr Ramadevi Wani.
I am sorry that you are still suffering with this pain and vomitting.

I have read your notes thoroughly. In my opinion, the reason for this pain is probably:

1. There is still a small stone in the common bile duct causing these symptoms.

2. You may be having sphincter of Oddi dysfunction. It is a condition in which the sphincter fails to contract and relax in normal fashion obstructing bile flow.
Gastroenterologists can explain it better.

Discuss with your gastroenterologist and have ERCP with sphincter manometry done. This may help in guiding further management.
Best wishes,
Dr Rama

Above answer was peer-reviewed by : Dr. Kampana
doctor
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Follow up: Dr. Ramadevi Wani (8 minutes later)
Wouldnt a CT Or endoscopy show this?
doctor
Answered by Dr. Ramadevi Wani (3 hours later)
Brief Answer:
ERCP IS NEEDED.

Detailed Answer:
Hi,
Welcome back.
CT or endoscopy would not show sphincter of Oddi dysfunction.
Best wishes,
Dr Rama
Above answer was peer-reviewed by : Dr. Kampana
doctor
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Follow up: Dr. Ramadevi Wani (10 hours later)
After looking into it and mentioning this and gastroperesis to the doctor they are trying to find soewhere to do an ercp. Thank you so much, I will let you know how the procedure goes if i get it done. You have given me hope as this makes so much sense compared to everything else. If this procedure comes back with no results what might be the next step? We have had so many tests and if it comes back negative I will be heart broken as there is no other answer but IBS AND This does not make much sense. Again thank you!
doctor
Answered by Dr. Ramadevi Wani (14 hours later)
Brief Answer:
Details below.

Detailed Answer:
Hi,
Welcome back.
Please note that ERCP+/-sphinctorotomy is a difficult procedure and should be done by experts in the field. It also carries a significant risk of complications. Do discuss in detail with your surgeon before going for surgery.

You may also consider trying antispasmodics and painkillers for some more time. In some the pain subsides with medicines only.
Best wishes,
Dr Rama
Above answer was peer-reviewed by : Dr. Kampana
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Answered by
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Dr. Ramadevi Wani

OBGYN

Practicing since :1985

Answered : 1363 Questions

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What causes upper abdominal pain and vomiting after gall bladder surgery?

Brief Answer: Get an ERCP ( endoscopic retrograde cholangio-Pancreatography) done Detailed Answer: Hi, Welcome to Healthcare Magic. I am Dr Ramadevi Wani. I am sorry that you are still suffering with this pain and vomitting. I have read your notes thoroughly. In my opinion, the reason for this pain is probably: 1. There is still a small stone in the common bile duct causing these symptoms. 2. You may be having sphincter of Oddi dysfunction. It is a condition in which the sphincter fails to contract and relax in normal fashion obstructing bile flow. Gastroenterologists can explain it better. Discuss with your gastroenterologist and have ERCP with sphincter manometry done. This may help in guiding further management. Best wishes, Dr Rama