Patient : For the past several months (3 or more) I have been having various abdominal pains normally on the RLQ and RUP however there are also bouts of LQ pain. In the past week I have noticed my throat swollen with glands visible, not painful. No fever.
The LRQ pain is in the area of a scar from surgery at birth. My belief is there is scar tissue aiding in the pain somehow. My bowel movements are typically on the hard, dry side, but I do have lose or soft stool from time to time. I have had acute pancreatitis 13 years ago and mono 22 years ago.
FOBT, H. Pylori, CBC, chest xray, and EKG normal prior to 1-15-12.
Abdomen ultrasound as follows:
Liver normal in size and echogenicity, measures 13.5 cm. no focal lesions seen. The portal vein is patent.
Gall bladder is unremarkable. No gallstones. Wall measures 2.0 mm in thickness.
No periocholecystic fluid.
Bile ducts are normal in size. Common bile duct measures 2.6 mm in diameter. Sonographic Murphy's sign is negative.
Pancreas is partially obscured by bowel gas. Visual portions unremarkable.
Fluid: no as cites is seen.
Spleen: at upper limits of normal size 13.2 cm in length.
Kidneys: normal in size and echogenicity bilaterally. Cortical thickness within normal limits.
Right kidney measures 10.4 cm in length. Left 10.1 cm. no renal masses seen.
No evidence of hydronephrosis or renal calculi.
Aorta and IVC: aorta partially obscured, no evidence of aneurism. IVC partially blocked by gas, visualized portion appears normal.
Where should I look next? The abdomen pain is still present, sometimes RLQ or RUQ sometimes LUQ.
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