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Forum Name: Gastroenterology Topics

Question: Is this a liver issue or gallbladder issue?


 shes_complicated - Mon Nov 03, 2008 9:32 pm

I have gallbladder issues on my mom's side of the family and when I recently started getting these "attacks" of pressure and soreness under my right rib and in my back and right shoulder no one was surprised. However, we attributed my dark green vomit to the azythromycin that I was taking for a sinus infection as with the diarrhea and vomiting (because they tend to give me an upset stomach). I was getting severe cramps that almost knocked me to the floor (upper abdominal cramps/spasms). Well, I finished the med, and the spasms/severe cramps stopped for a couple days. (I took a 3 day pack, Tues, Wed, Thurs). The diarrhea stopped on Wednesday and then I couldn't go. So I bought some Benefiber and took 3 tabs 3xs a day for a couple days and ate a bunch of lettuce. Tuesday came and I had diarrhea again. Very strange in color..but..maybe it was the lettuce...

ANYWAYS, I ended up doubled over in severe pain again on Wednesday (last wednesday). Couldn't stop the pressure this time. It didn't come and go, it got worse and worse. I went to the ER on Thursday because I was so pale and my temp was 99.5 and the pressure and soreness (sore to the touch and when I'd breathe) was horrible...I was vomiting again everytime I ate...

The ER did an ultrasound of my gallbladder immediately thinking I had gallstones. But, instead, this is what the report said (I asked for a copy of the report for my PCP and made a copy for me just in case its important somehow).

""There is a mildly hypoechoic hepatic parenchymal echogenicity with slight echogenic promience of the portal triads. This finding is non-specific and may reflect acute hepatic parenchymal disease such as hepatitis. Correlation with LFTs and serology is recommended. There is no intrahepatic or extrahepatic biliary ductal dilatation. The liver and spleen are otherwise normal in size and configuration.

The gallbladder is normal without echogenic debris, stones, or mural thickening. No pericholecystic fluid or sonographic Murphy sign was detected. Visualized portions of the pancreatic head and body are normal. The right kidney is normal.

No evidence of cholelithiasis or cholcystitis."

It's still sore to the touch on my RIGHT side from my sternum all the way to the side of my right rib...What is it? =/
 John Kenyon, CNA - Sun Dec 07, 2008 10:48 pm

User avatar Hello -

While the report seems to make it clear the gallbladder is not the culprit, the symptoms certainly would lead one there first, and I'm not convinced it's not at least part of the problem. The symptoms are classic for cholecystitis, although if there's nothing (debris, "sludge", stones) inside the gallbladder it makes it less suspicious for sure. However, the gallbladder can still be irritable in certain people, and become inflamed without showing any evidence of anything solid or semi-solid inside it.

There is also a possibility of atypical presentation of some form of hepatitis, and one would expect the attending physician would read the report you've quoted here and at least order a hepatitis panel and liver function tests to rule out some liver involvement. It's even recommended in the report that this be done. That would be the logical next step. Almost everything else would appear to be normal, and obviously something is not. The report is mostly good news and the rest is non-specific. The symptoms, however, suggest something is going on over in that neighborhood, and blood work is absolutely essential to figure out what it is. This should be fairly simple. Should already have been done. Hopefully by now it has.

Please follow up with us when you've learned more, or if you should develop any new symptoms (or even if you lose a few of them). Best of luck to you.
 joker_29 - Wed Apr 22, 2009 5:04 pm

Hi dear sir I've got a sick brother he's got a liver influmation typ C (2000)...he did catch this illness in hospitalhe has taken interferon in the hospital but this medicament destroyd his bone marrow,the doctors don't treat him any longer and he has huge problems with immunity,he has just 10% of immunity in his body,we are without medical help...please i need an advice how to help my brother,I'm wrighting from Poland
 John Kenyon, CNA - Mon Apr 27, 2009 11:41 pm

User avatar Hello --

While interferon can cause hemolytic anemia and damage the immune system, often making the patient rather sick, once the drug is discontinued the problem almost always corrects itself with time. During recovery (and with Hepatitis C anyway) good nutrition if of great importance. If for some reason the bone marrow doesn't regrow as it should, and your brother remains ill for a long period of time, it may be necessary for him to have a bone marrow transplant, although I have not yet heard of interferon causing an anemia this critical. It is a thought, however, in case the drug was somehow over-administered.

I hope this is helpful to you. Again, this should resolve on its own once the medication is stopped, but can take quite a while. Your brother should be seen by a hematologist for evaluation of regrowth of marrow and to consider the possibility of a therapeutic marrow transplant if this should be deemed necessary.

Good luck to the both of you.
 joker_29 - Wed Apr 29, 2009 3:01 pm

Hello...It's a liver influmation not gallblader issue...like you said sir he had anemia...doctors shouldn't give him interferon but they did...we cant get any visit in hemetologist because it's take a months to get a visit in doctor office,we were traying but without success...what I can do in this situaction? maybe I shouldnt ask but I'm losing hope....!

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