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What Causes Upper Right Abdominal Pain Radiating To Back?

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Posted on Thu, 21 Jan 2016
Question: Hello Dr,

I am a 38 yr old female and I have been suffering from upper right abdominal pain radiating to the back on and off for 1 year. The pain feels like burning and sometimes sharp. I have had blood tests showing a slightly elevated lipase level a few times. I have had ultrasounds to look for stones in the GL but there weren't any. Had a CT, an MRI and MRCP to investigate GL and Pancreas, all of which came back normal. I also had an endoscopy which was normal. Nephrologist suggested a colonoscopy as he was certain that pain was not coming form the cyst in my right kidney. I am currently suffering from an episode that has lasted 1 month so far. I do have some upper back pain as well radiating between the shoulder blades and what feels like heart burn. Is there a way to conclusively diagnose chronic pancreatitis or is it possible that these symptoms are mimicing something else? I am in severe pain especially at night and upon waking to the point where I am unable to find a comfortable position to sit or lay. You expertise and suggestions are so very much appreciated. XXXXXXX
doctor
Answered by Dr. Dr. Ivan Romich (2 hours later)
Brief Answer:
few possible causes

Detailed Answer:
Hi and welcome to HCM.
You've done very sensitive tests and I am suprised that nothing is found if you have such severe pain.

If pancreatitis, gallbaldder stones and stomach ulcers are ruled out then some less common disorders may be considered such as right basal pleuritis, autoimmune hepatitis, gallbladder dismotility, or neural radiculopathies.

Colon and small bowel diseases are possible causes as well , so colonoscopy and small intestinal endoscopy should be done.

Pancreas related disorders would be more felt on the left side but in your case chronic pancreatitis can't be excluded.

Less common cause but more serious is disease of lymph nodes around abdominal arota. If nothing is found on colonoscopy, I think that MRI of the whole abdomen and thorax should be repeated.

Let me know if there are any further queries regarding.

Wish you good health.
Regards
Note: Revert back with your health reports to get further guidance on your gastric problems. Click here.

Above answer was peer-reviewed by : Dr. Arnab Banerjee
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Answered by
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Dr. Dr. Ivan Romich

General Surgeon

Practicing since :2008

Answered : 13886 Questions

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What Causes Upper Right Abdominal Pain Radiating To Back?

Brief Answer: few possible causes Detailed Answer: Hi and welcome to HCM. You've done very sensitive tests and I am suprised that nothing is found if you have such severe pain. If pancreatitis, gallbaldder stones and stomach ulcers are ruled out then some less common disorders may be considered such as right basal pleuritis, autoimmune hepatitis, gallbladder dismotility, or neural radiculopathies. Colon and small bowel diseases are possible causes as well , so colonoscopy and small intestinal endoscopy should be done. Pancreas related disorders would be more felt on the left side but in your case chronic pancreatitis can't be excluded. Less common cause but more serious is disease of lymph nodes around abdominal arota. If nothing is found on colonoscopy, I think that MRI of the whole abdomen and thorax should be repeated. Let me know if there are any further queries regarding. Wish you good health. Regards