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Dr. Andrew Rynne

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What does my lab test report indicate?

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Dr. Hari Charan Perigela

General Surgeon

Practicing since :1995

Answered : 2288 Questions

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Posted on Wed, 15 Mar 2017 in Liver and Gall Bladder
Question: Hello I a, a 64 year old white male with symptoms as follows : sharp non radiating pain that comes without a known stimulus , like exercise, eating spicy food , etc . The pain is mid epigastrium and radiates toward the right scapula. I am status post pacemaker insertion for so called sick sinus syndrome secondary to idiopathic cardiomyopathy. This pain does not seem to be cardiac in nature . I underwent CT with contrast of abdomen and ultrasound and Nuc Med to rule out gallbladder , the studies were normal.
the pain is elusive and not I am not able to say how often it occurs but pushed I would say rare , however when does present it is quite painful greater than 7 if 10 is awful, it is fairly short in duration but doesn't seem to respond to acid pump inhibitors , h2 blockers, or chalk like acid reducers .. a physical exam would be fairly normal , 5'7 137 lbs . Heart and lung sounds normal , slight grade 1/2 soft systolic murmur . ETT was normal. Abdomen soft and non tender , splenomegaly or hepatomegaly < blood chem is unremarkable , Lipid is triglyceride 90, Total Cholesterol 160 , LDL 70 and HDL 58 particle LDL using NMR method is B profile is moderate risk 8% for 5 year. Do you think it could be esophageal , about 10 years ago I had egd for similar and reflux and Hiatal Hernia were discovered ... I did have pancreatitis 25 years ago required short hospital stay of 5 days . thanks
doctor
Answered by Dr. Hari Charan Perigela 3 hours later
Brief Answer:
It could be Gastro esophageal reflux disease.

Detailed Answer:
Hi
As per your description, it could be Gastro Esophageal Reflux disease(GERD).I am getting good results with newer Proton pump inhibitor like Ilaprazole 10mg before food.
Avoid spicy food,pain killers.
If there is no response, Pancreatitis has to be excluded. Pancreas is present in the epigastrium.Any disease of the pancreas like Pancreatitis will cause pain in the epigastrium with radiation .MRCP will give a clue.
Hope I answered your query.
If you have any questions, I will clarify further.
Wish you good health.
Regards
Above answer was peer-reviewed by : Dr. Remy Koshy
doctor
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Follow up: Dr. Hari Charan Perigela 10 hours later
Thank you sir , I thought GERDs too , and will try another proton pump inhibitor > I am fairly concerned about a pancreatic disorder and I have it looked into, I have a non functioning DDDR pacemaker , so I don't know if I can have MRI safely >
Thank you again
doctor
Answered by Dr. Hari Charan Perigela 32 minutes later
Brief Answer:
You can go for blood tests.

Detailed Answer:
Hi
Blood tests like Serum Amylase and Serum Lipase
can give a clue about Pancreatitis.
Good Radiologist will tell the Status of Pancreas even in Ultrasound abdomen.
If you want MRI, you should consult your Radiologist and proceed further.
Wish you good health
Regards
Above answer was peer-reviewed by : Dr. Prasad
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