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Forum Name: Surgery Topics

Question: moderate to severe pain right ribcage 3wks after surgery?


 buaygal31 - Wed Nov 18, 2009 2:24 pm

3 weeks ago I had both my right ovary and a dermoid cyst on the ovary removed. During surgery the cyst ruptured and I subsequently needed to be "cleaned" out. The procedure was laproscopic.

Immediately after I had severe pain in the upper right side along the ribcage and up under the ribcage (almost where the gall bladder would be). I was told this normal and would subside. It took 6 days but the pain started to go away and was gone completely by the 9th day.

Suddenly, yesterday at 22 days post surgery and 13 post initial pain, the pain is back. It started as a dull pain but slowly grew over the last 24hrs to where it is close to severe again. It hurts to take a deep breathe in and if I touch the spot along the bottom of the ribcage it hurts and I actually make it worse.

Initial reaction of people is that it might be my gall bladder but I had that removed 13 months ago after a severe attack of stones! And this pain is exactly the same as what I had post surgery.

Not sure what to do or if this is even related to the surgery.

Charlene
 Dr.M.Aroon kamath - Tue Nov 24, 2009 10:27 am

User avatar Hi,
During laparoscopic surgery, carbon dioxide is insufflated into the peritoneal cavity to distened the abdomen prior to inserting the laparoscopic instruments.The carbon dioxide mixes with water to form carbonic acid, which is an irritant to the peritoneum.This results in local as well as referred pain.

As your surgery is fairly recent, before jumping to any other conclusions, this should be considered as the most likely cause.

At the completion of some of the laparoscopic procedures, it is usual for the surgeons to wash that part of the peritoneal cavity with normal saline(this is sucked out eventually).Some of this saline may remain, and track upwards towards the liver, where eventually it gets absorbed under the liver via lymphatics.This remaining fluid can cause temporary pain in some individuals.

It may be prudent in your case to wait for a while this process eventually settles down.In case the pain does continue, then further investigations may be warrented.

Best wishes!

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