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Post-cholecystectomy or gallbladder removal surgery
Hi – I had my gallbladder removed 17 years ago and have chronic, sharp back pain behind the port incision. That incision was in my upper left abdominal quadrant; the pain is felt in my back, directly behind the incision. It is thought that I have an adhesion in my upper left quadrant. Is it possible that nerves are trapped and that it causes referred pain in my back? The pain is nauseating and hasn't improved. I have been on anti seizure medication and a pain killer that isn't a percocet-type medication. I am curious if anyone else has persistent pain in their back following gallbladder surgery. If so, how is your pain treated.
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Hello @lilmo and welcome to Mayo Clinic Connect. Can you share more about your question to @lag911 to provide a bit more background?
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1 ReactionCurious about a few things, what do you mean by port Incision? Was something placed during the surgery? Also do you follow a low fat diet?
The wife has had the following PAIN events & SURGERY to remediate:
* 5 level 10 pain episodes lasting on average 30-45 minutes
* Pain is in the sternum and just below it, it radiates to the back, it is unbearable
* Dates of pain:
* 8.27.21 < level 10
* 8.28.21 < level 10
* 8.30.21 Level 10 - "worse than childbirth"
* 8.31.21 < level 10
* 9.13.21 Level 10 (ER visit details below)
* 9.15.21 < level 10
* 9.17.21 < Level 10
* 10.31.21 Level 10 "worse than childbirth"
* 11.1.21 Level 10 "worse than childbirth"
* 11.4.21 gallbladder removed / cholecystectomy
* 2.9.22 Level 10 "worse than childbirth"
TESTING:
* 11 blood-work tests from 9.13.21 - 02.10.22
* 9.13.21 XR Chest single vw - no acute cardiopulmonary process
* 9.13.21 EKG normal
* 9.13.21 ED US Aorta - Aortic Ultrasound, no evidence of abdominal aortic aneurysm
* ED US Biliary - gallbladder without any signs of cholelithiasis or cholecystitis
Second ER visit, different hospital
* 11.4.21 CT ABD Pelvice-iv only - Moderate extrahepatic biliary ductal dilation without visualized obstructing mass lesion no intrahepatic biliary ductal dilation, differential of which includes stricture, spasm, and non visualized ampullary stone. Correlation which cholestatic enzymes may be useful. Mild gallbladder distinction with mild to moderate gallbladder wall thickening without visualizing gallstones, differential of which includes mild cholecystitis. Moderate prominence of the extrahepatic bile ducts with maximal diameter of the common hepatic duct of 11mm and maximal diameter intrapancreatic portion of common bile duct of 11.55mm...without visualized obstruction calculus or mass lesion. No intrahepatic biliary ductal dilation.
*11.4.21 MR MRCP Details - There are 203 small hepatic cysts (largest in the posterior segment - 17,, with o suspicious hepatic mass or concerning lessons, stomach and spleen, and pancreas are unremarkable - not sure what organ cysts are on but later ultrasound indicates there are cysts on liver... Mild GB wall thickening, mild CBD prominence (10 mm series 5,) which tapers smoothly to the level of the ampulla, MRCP imaging demonstrates no filling defects to suggest choledocholithiasis.
* 11.4.21 - OR Cholangiogram intaop rad details, nine-spot images under fluoroscopy were reviewed, no fillings defects are noted in the common bile duct, dilation of the common bile duct is noted
* 11.4.21 Gallbladder removed
* 02.09.21 Level 10 pain event - same symptoms / pain as before gallbladder was removed
BLOODWORK:
Any thoughts that would lead her to a path to green? Are we even looking under the correct rocks (digestive related)?
Look into Median Arcuate Ligament Syndrome. It has very similar symptoms to a gallbladder attack. Pain in the same area and it can be quite severe. It's not picked up with conventional testing so it's easily missed. If the symptoms seem to fit, ask a GI doc about it and get them to order a mesenteric artery duplex ultrasound.
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1 ReactionI think she should have some repeat imaging done, looking for blockage of bile ducts.
I also agree that testing for MALS should be done.
@jhmontrose & @astaingegerdm Thank you! She has an appointment scheduled with a GI doctor on March 2, 2022, and we will ask for the mesenteric artery duplex ultrasound /MALS scan as well as more imaging focusing on blockage of the bile ducts. This information is greatly appreciated, thank you again for your time and insight!!
I had my gallbladder laparoscopically 6 days ago. On Friday night, I began to have this uncontrollable itch all over. I went to the ER the next morning and it was discovered my liver enzymes were significantly elevated (see attached picture). They even reached out to my surgeon who ordered an ultrasound because he did not like my numbers. Preliminary results showed nothing was wrong. They gave me two prescriptions to help with the itching until I follow up with the surgeon on Monday. Based upon my liver enzyme numbers, how concerned should I be?
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2 ReactionsHi @tamekabonner and welcome! You will see I moved your post to a discussion that is talking about the same thing. Mayo Clinic Connect is a platform where patients can connect with other patients to share and compare health issues.
What type of Rxs did they give you and did your surgeon say why the ultrasound was ordered?
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1 Reaction@amandaburnett Thank you! I was given Hydroxyzine & Famotidine.
My surgeon ordered an ultrasound, because he wanted to ensure there wasn't a blockage in the bile ducts. The results were released this morning it stated that the common bile duct was not definitively imaged.