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Treatment for ACUTE abdominal pain with CHOLELITHIASIS.

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I was diagnosed with Cholelithiasis and abdominal pain, acute, right upper quadrant. The hospital called my back on Monday and added cyst on liver, right kidney looks irregular and possible pancreatitis to the diagnosis. The pain has continued for more than 72 hours. I am on pain killers. Changes in symptoms since going to ER - Pain occasionally worse, dark urine, abdomen now tender to touch, feel pain when breathing in. Appetite has returned, no vomiting, and no fever. I don't have a followup appointment with an Internist until Nov. 3. Just moved and do not have a regular doctor. Should I return to the ER and not wait for Nov. 3? How long is a normal time period for the pain to last? I don't have insurance at the moment so don't want to go if not necessary but can't seem to get any medical advice.

Category: Gastroenterologist, Medical

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Category: Hepatologist
 22 Doctors Online

Thanks for posting your query at
I am Dr.R.K and I am pleased to assist you.
You have not uploaded the scan report and I presume you have cholecystitis due to cholelithiasia ( inflammation of gallbladder due to stones).
Pancreatitis is less likely as your serum lipase level is within normal limits
Your total white cell count is high.
So in addition to the painkillers you may require a course of antibiotics.
Usually you get relief in 24-48 hours.
Right upper quadrant pain may be due to other causes as well like acid peptic disease.
Since you are having some degree of symptom relief, I would advise you to take prilosec along with the painkillers.
If there is worsening of symptoms, you can go to ER again for reevaluation and for prescription of antibiotics.
I hope that answers your question.
Let me know if I can assist you further.

Patient replied :

I am not able to upload the sonogram. I did receive an EKG report and it was all normal. I spoke with the advice nurse and this is the info she added and cleared up:
-The note on the pancreas is not pancreatitis. It was found to have fatty infiltration and she wants me to discuss that situation with my follow up appointment with the internist.
-The kidney lesion is 1.1 cent.angiomyolypoma and considered benign.
-The cyst on the right kidney is also considered benign.
-I have been able to reduce my pain killer pills from 1 every 6 hours to 1 every 12 hours as of now.
-She indicated to return to he ER if my pain worsens, get a fever, or start vomiting.
I am working with the doctor's office to move my appointment up to an earlier date if someone cancels. I have not eaten much since Saturday morning. A piece of toast, 1/2 apple, some organic applesauce, and some warm organic apple juice. I am drink as much water as I can. Do you have any other suggestions for food intake since my appetite seems to be coming back.
Holly Bordwell


Thanks for the additional information.
Yes you need to go to ER if there is worsening of pain or if there is fever.
As far as diet is concerned you need to avoid fatty food and spicy food. It means there is no restriction for other food items.

I hope that answers your question.
Let me know if I can assist you further.

Dr. Ratnakar Kini
Category: Hepatologist
Fellowship - DM - TN Dr.MGR Medical UniversityResidency - TN Dr.MGR Medical University Medical School - Stanely Medical College, TN Dr.MGR Medical University
Dr. Ratnakar Kini and 4 other Medical Specialists are ready to help you

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