Medical Mystery, Conflicting Symptoms

Patient

Q: I went into the ER with severe abdominal burning and I was vomiting most of the night! I had a white cell count of 19! The next morning my burning pain stopped just as I stopped vomiting! My white cell count was now a 22! I was given two antibiotics for my gall bladder than sent home! I started to develop major abdominal tenderness and I went back to the hospital and my white cell count was now a 31! I was given another antibiotic and a shot of toradol which stopped the pain very fast! I was given ultrasounds, CT scan, Chest X-ray and the doctors where puzzled, they said my gall bladder didn't look bad enough for my symptoms! The next morning my white cell count dropped to 19 and the following morning it was back to normal! A hydria scan revealed my Gall bladder was blocked so it was removed! I was sent for a scope Endoscopy and the results where I'll negative but the doctor said my duodenum had a little bit of inflammation but was not worried! I was also given an MRI and it was clear! I'm wondering if my duodenum got infected and caused my Gall Bladder to also flare up and maybe that's why I had such a hi white cell count and so many different symptoms!

Symptoms:  Abdominal burning, vomiting, abdominal tenderness, hi white cell count
Doctor

A:   Hello
Welcome to Ask The Doctor.
You probably had Cholecystitis that is the inflammation of gall bladder leading to pain abdomen and increase in WBC count due to infection. I suppose the appendix had no sign of inflammation on CT scan that's why it was not considered as a cause.
A lot many times an obstruction in Common bile duct can cause Cholangitis and possible Acute Pancreatitis that could have caused these symptoms.
Since you were not mentioned this, so i assume that Pancreas would have been normal.
Now, if you are improving after cholecystectomy and your WBC counts are settling down , you don't need to go for any further intervention.
I hope it helps.
Stay Healthy.

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