abdominal pain but nothing shows on ct scan

So many things can cause abdominal pain, and it is very difficult to diagnose. In some cases, they think its nothing serious but want to make sure with a CT. CT scan for abdominal pain most commonly also covers the pelvis. We want the forums to be a useful resource for our users but it is important to remember that the forums are Finding out the history of the illness, as well as your medical history, helps narrow down the potential causes. I am so sorry to hear what you are dealing with and hope today you are having a good day. Hey Sue, I feel your pain!! While abdominal pain is common, each case is unique. If the image is focused on the wrong area, it'll miss the source of the problem. Cause of a fever. There are some reasons that a non contrast CT will be done. Posted When I went to the ER it was just for the EXTREME abdominal pain. This can be an understandably frustrating situation for patients. I know my own body and I know it is NOT the IBS and wish people would listen to me!! The appendix is a worm like structure at the base, Read More Early Appendicitis on CTContinue, Please read the disclaimer Free air or pneumoperitoneum is air that is in the peritoneal cavity of the abdomen. Gall bladder stones which can be seen on ultrasound cause pain in right-upper abdomen which is worse after you eat and can be worse at night as well. i have just had a Gastroscopy which showed nothing either. Always speak to your doctor before acting and in cases of emergency seek A computed tomography (CT) scan is a type of CT scan. An MRI isn't safe for people with certain types of metal in their body. Appendicitis is a good example of a condition that can sometimes require re-evaluation . Read More Acute Appendicitis on UltrasoundContinue, Please read the disclaimer Early appendicitis on CT may be a subtle finding that requires a skilled radiologist to diagnose. It is in my abdomen and down by my hip bone- so more pelvic I guess. A person viewing it online may make one printout of the material and may use that printout only for his or her personal, non-commercial reference. I have also read that you can get bone spurs in your pelvis. This includes life-threatening infections, bowel obstructions, abnormal fluid or bleeding, kidney stones, masses or tumors, abnormalities of the blood vessels that run through the abdomen, the list goes on. This has been happening for 3 days and I have lost 4 lbs from it. They dont usually need to run labs or tests. Raewynne . Right now with covid still ongoing it may be difficult to get an appointment. This is a classic example of older patients with abdominal catastrophes presenting with pain in the wrong location. Although some studies have shown similar sensitivity of ultrasonography compared with CT for detecting diverticulitis, others have shown significantly lower sensitivity with ultrasonography.19 Variation in ultrasonography results may be due to the highly operator-dependent technique and the limitations of patient body habitus, compared with other imaging modalities. The American College of Obstetricians and Gynecologists. Magnetic resonance imaging is another emerging technique for the evaluation of abdominal pain that avoids ionizing radiation. In the interest of decreasing radiation exposure, efforts have been made to use CT more judiciously. Have had stomach pain for over a year with swelling. If the left upper quadrant hurts after a serious car accident, the cause of pain could be the spleen. Jennifer Whitlock, RN, MSN, FNP-C, is a board-certified family nurse practitioner. Dec 13, 2021. You'll have anesthesia and will be sedated throughout the exam. Unfortunately, I still have some very chronic aching on my right side (where . Sometimes I may be constipated and sometimes i have diarrhea. translation, interview, author | 7.2K views, 15K likes, 7.1K loves, 109K comments, 26K shares, Facebook Watch Videos from Agyemang Elvis: ALPHA HOUR. Connect with thousands of patients and caregivers for support and answers. Try our Symptom Checker Got any other symptoms? Read our editorial policy. CT scan for abdominal pain most commonly also covers the pelvis. Initially, Bland was concerned she had appendicitis, Boodman writes. I just discovered if I push intensely between my back ribs, that I have somewhat relief from the pain. It is also common that our ED workup does not find an identifiable cause, and patients are discharged home without a clear diagnosis. Evaluation of Acute Abdominal Pain in Adults. https://patient.info/forums/discuss/normal-tests-but-still-have-upper-abdominal-pain--454405. Not trying to be negative Nelly here,. Please consider the clinicians recommendations regarding follow-up, whether it be a primary care doctor or a specialist. A CT scan can only show if something looks abnormal, not if it functions abnormally. As Sue said a heating pad will help. ive had so many tests and everything has come back clear, yet i am still in pain ( it isnt severe pain just a dull uncomfortable pain, sometimes a sharp pain) the pain does come and go bit is happening daily. We might be in the same boat. The CT is often done after giving contrast through the vein and after you drink oral contrast. Registered number: 10004395 Registered office: Fulford Grange, Micklefield Lane, Rawdon, Leeds, LS19 6BA. It took me a while to recover, and I would hope that at this point, I would be completely recovered. This may mean drawing blood, taking a stool sample, or collecting a sample of saliva, among other options. Does anyone else have any ideas? The American College of Radiology (ACR) has developed evidence-based guidelines, the ACR Appropriateness Criteria, to help physicians make the most appropriate imaging decisions for specific clinical conditions. The second time I went to a different hospital. respect of any healthcare matters. The cause of the abdominal pain may not be seen because it requires a different type of test to diagnose. The cramping is kind of all over. I would try and get ultra sound done of pelvic area. Because so many health conditions can cause abdominal pain, you may need tests to identify the problem. I'm in discomfort/pain everyday. Abdominal CT scans can help identify the cause of sudden belly pain and are usually needed to confirm kidney stones, pancreatitis, or appendix ruptures. Results did not show any emergency findings. and Privacy Policy and steps will be taken to remove posts identified Joanna. Perhaps there are some blood tests I can get done on my own? Egton Medical Information Systems Limited. Exam of the Abdomen. If you have, you may have some, or extensive, adhesions. This is a classic example of older patients with abdominal catastrophes presenting with pain in the wrong location. Diagnostic tests: Imaging for chronic abdominal pain in adults, Imaging for chronic abdominal pain in adults. PO Box 601504 I also dont know what to do anymore. Patient aims to help the world proactively manage its healthcare, supplying evidence-based information on a wide range of medical and health topics to patients and health professionals. The differential diagnosis of acute nonlocalized abdominal pain is broad. So l dont really understand it, as soon as l had gall bladder probs confirmed l went on list to have it removed, key hole surgery for chocylitus, less than 2 days in hospital, symptoms went with it. You can't always see blood in the stool with the naked eye. CT scans aren't the most reliable way to diagnosing colon cancer. Thank you, {{form.email}}, for signing up. Forty-nine percent of patients had their diagnosis changed after a CT scan. . ive had issues with acid reflux for nearly 2 years but it hasnt caused abdominal pain. Imaging tests used may include a CT scan or an ultrasound. It is more common in older individuals. The ED physician ordered labs and IM ketorolac. Doctors often diagnose viral gastroenteritis based on symptoms. A chronic illness is one that lasts six months or longer. They made me drink some nasty tasting stuff and did a CT scan and Xrays. It is almost like a burning, gnawing feeling. Still the same really, upper left abdominal pain has gone from being constant to just appearing sometimes throughout the day for a few minutes, still having mid/upper back pain, its a strange feeling its not painful just uncomfortable especially when in certain positions and the feeling moves around my back. Any associated symptoms like vomiting, fever, or lab abnormalities such as an elevated white blood cell count. yes i have had three rounds of bloods, mri of abdomen, ultra sound and endoscopy - all clear. I dont know what more i can do or ask my GP to do? Have pain in right side. . EM physicians are often ridiculed for ordering too many CT scans. For example, pain could be a sign of an ectopic pregnancy. Read our editorial policy. i suffer with really bad health anxiety but my GP isnt interested in my symptoms anymore and said only lifestyle changes will help. Posted Do you have diarrhea or constipation? I think anxiety hasnt helped my symptoms either i was constantly googling my symptoms and it was coming back with the worst results possible, but thankfully all my scans have been clear. This article explains some of the most common tests used to find the source of abdominal pain. I have tried even medication under the sun from anti-acids, nerve pain, ulcer medication and not currently just on tramadol to manage the pain, although it does not take the pain away but dulls it enough for me to go about my day to day life and be able to sleep. Oral contrast media is used for bowel visualization, and intravenous contrast media allows for enhanced visualization of vascular structures and solid organs.25 The ACR Appropriateness Criteria outline whether contrast is recommended for various indications (Tables 1 through 5312 and eTable A), and note that protocols on the use of contrast media vary among institutions. Patient is a UK registered trade mark. ive ended up in A&E due to the pain where they conducted a chest x-ray, ECG, blood tests for liver and kidney and Pancreas all which were clear and in normal levels. It is almost like a burning, gnawing feeling. Stomach pain and swelling is worse when I eat, and after I eat. What was the outcome? The hospital and my GP said it was just Acid. I am not even convinced those things are even causing all my symptoms. A CT scan shows detailed images of any part of the body, including the bones, muscles, fat, organs, and blood vessels. You would have to have a scan to detect it. I read it all the time. Adding a dose of ketorolac on top of this certainly did not help. As mentioned, some diagnoses cannot be made initially, but the evolution of the underlying condition and the resultant development of new symptoms requires re-evaluation. Why do I still have abdominal pain if the CT scan is normal? CT will often help in either ruling in important causes of abdominal pain or help exclude them. It also explains when to seek medical care. So there is a latest, test of sensitivity or allergy for all types of foods your dietition doctor know it. In some cases, doctors may do stool tests to rule out other gastrointestinal diseases, such as ulcerative colitis. I wake up with the pain and it can last all day. If you want to learn how to write expert reports, the MedMalReviewer service is really good. Hi there, it's hard to say what it is that your'e suffering from because stomach pain is pretty vague. Have had hida scan, CT scan, ultra sound. .. and there are so many things it could be..a journal will help in diagnosis. ive ended up in A&E due to the pain where they conducted a chest x-ray, ECG, blood tests for liver and kidney and Pancreas all which were clear and in normal levels. Have seen 2 speciialists so far, and seeking a 3rd specialist now. If you have to go to an emergency room. This test allows a physician to inspect the inside of the colon (large intestine) with an instrument that has both a light and a camera. when i mention this she just dismisses me saying all your tests are clear if you had something wrong we would of found it. A radiologist can "read" the picture. An approach to narrowing the differential diagnosis based on history, physical examination, and laboratory testing, in addition to imaging, is outlined in our previous article on this topic.2 If a likely diagnosis is apparent based on the clinical presentation, imaging may or may not be indicated (Table 1312 ). All Rights Reserved. She was prescribed Zofran, referred to GI, and discharged. One of the best ways to diagnose this kind of pain is a physical examination of the abdomen performed by a trained clinician. Lipase or amylase for the diagnosis of acute pancreatitis? Patients often ask about a prescription medication when going home with ongoing symptoms. Pelvic exams involve checking reproductive organs, including: A healthcare professional will check for signs of infection, irritation, cysts, or other growths that could be causing pain. One way to diagnose a health problem is to analyze substances in your body. A CT (computed tomography) scan, also called a CAT scan, is a type of specialized X-ray. Patient started on new medication and goes to the ED after slowly developing a rash. The Celexa should start working in the next couple of weeks or so. She survived but had a long and difficult recovery. The CT suggested abnormal densities in the pancreatic head. Many cases of unexplained abdominal pain will resolve on their own and are likely due to a transient period of maldigestion. Registered number: 10004395 Registered office: Fulford Grange, Micklefield Lane, Rawdon, Leeds, LS19 6BA. A 57-year-old woman presented to the ED on January 6 with lower abdominal pain. pheochromocytoma. A healthcare provider inserts a lighted endoscope with a camera into the mouth. Abdominal pain is a common medical problem. Abdominal persistent pain. She tried the FODMAP diet and that did not work. Cause of abnormal blood test results such as liver or kidney problems. My daughter had symptoms similar to yours (stomach pain so bad we ended up at emerg a few times). In the meantime, lying down with a hot pad on your abdomen may give you a bit of relief. What is wrong with me? What to Expect From a Transrectal Ultrasound, Types of Colitis: Everything You Should Know. Treated for H Pylori and then told that was not the issue. Every ED clinician hopes to be able to diagnose and treat the cause of a patients pain, providing immediate relief and a resolution to the patients discomfort. Posts: 3. Registered in England and Wales. Data Sources: We reviewed the American College of Radiology Appropriateness Criteria at https://acsearch.acr.org/list. Examples of conditions that we would not diagnose on CT scan or ultrasound include viral infections (the stomach flu), inflammation or ulcers in the stomach lining, inflammatory bowel disease (such as Crohns Disease or Ulcerative Colitis), irritable bowel syndrome or maldigestion, pelvic floor dysfunction, strains and spasms of the muscles in the back and abdomen, to name just a few. Sometimes these scans involve the use of special dyes called contrasts. And the scans increased how certain doctors said they were about their diagnosis, from 70.5 percent to 92.2 percent, on . 2015;38(2):49-54. doi:10.18773/austprescr.2015.019. RNY on 06/04/09. This may mean drawing blood, taking a stool sample, or collecting a sample of saliva, among other options. renal cell carcinoma. Therefore, even a negative CT of the abdomen has a lot of value. But contrasts aren't safe for everyone. the only thing was i tested postive for h pylori which i was treated for and had it tested again and was clear. By looking at samples of your blood, urine, stool, and enzymes, they can identify disorders that may be causing your pain. Strong lower abdominal, vomiting water - 2 MONTHS ON & OFF, Severe upper abdominal pain radiating to back, Severe upper left abdominal and back pain after eating solid foods, Extreme Abdominal pain and breast discharge, I had my gallbladder taken out in 2006 and I haven't been the same since, Ongoing, worsening, severe, upper right abdominal pain that, CT Abdomen and Pelvis W/WO Contrast Exam results, 6 Things You Should Know About Eating Disorders, Chronic Constipation And Gastrointestinal Health, Signs And Symptoms Of A UTI (Urinary Tract Infection) In Children. Pain that improves after ketorolac does not necessarily indicate a musculoskeletal etiology. It is also common that our ED workup does not find an identifiable cause, and patients are discharged home without a clear diagnosis. @jojo13 And that is not in the "normal" range for eGFR it is not terrible. In general these days there are a lot of gluten sensitivity, at most patients whom have undignosed theirdiseases. She had a perforated duodenum with pain in the RLQ. I am bloated and nauseas most of the time. I have been diagnosed with Mild Gastritis, Bad acid reflux, and a hiatal hernia. This scan uses many x-ray type images to create a picture of the inside of the body. At this point, will have to wait to retest CEA and if it's still elevated, CRC surgeon suggests exploratory surgery of my abdomen to see if he can see something the scans are not picking up. Undiagnosed Abdominal Pain EXTREME abdominal pain. Imaging tests use magnetic fields, x-rays, or sound waves to create detailed pictures of the inside of your abdomen. Notes on Help? Diverticulitis is often diagnosed clinically without radiologic examination, but imaging should be considered if the diagnosis is unclear or if complications (e.g., abscess, fistula, obstruction, perforation) are suspected (Figure 3). They may also take tissue samples and perform other minor procedures. Any advice??? They did an ultrasound of my liver, gallbladder, Pancreas, Right Kidney and I also had a chest x ray along with bloodwork. In all cases, an experienced physician will be needed to combine all the known information, including CT scan of the abdomen to reach a final diagnosis. If you are of childbearing years and you have abdominal pain, a pregnancy test might be a good starting place. She was prescribed Zofran, referred to GI, and discharged. Abdominal CT exposes a patient to an effective radiation dose of approximately 10 mSv, compared with the annual background radiation dose of 3 mSv in the United States.22. I am bloated and nauseas most of the time. So there is a latest. We want the forums to be a useful resource for our users but it is important to remember that the forums are Depending on the results, you may need further tests. For most locations, the ACR provides several clinical variants (e.g., presence or absence of fever, leukocytosis, pregnancy) and outlines the appropriate imaging for each scenario. Good luck Im gonna pray for you and me tonight.. If you are have abdominal pain, dont be surprised if your healthcare provider asks a lot of questions. when symptoms began, what makes it better what makes it worse. Other liver tests indicate whether the liver is removing enough harmful toxins from the body. 11. 32, 33 CT scans also can reveal . They did a bunch of blood work and it came back as high white blood cell count. Have you had any abdominal surgeries? All the doctors are trying to blame it all on my IBS, which I have had since I was 18, but I have never had any pains like this in the 10 years that I have had and not had any bad episodes with it in years as I have learned to manage it. These tests can be helpful in finding the cause of abdominal pain. Lower abdominal pain during the third trimester of pregnancy. Workup included CT scan and labs. It is FREE! If blood is there but you can't see it, you may have a problem in your upper digestive tract. If you haven't right down notes . History, physical examination, and laboratory testing are often insufficient for diagnosing acute cholecystitis without further workup.13 The ACR Appropriateness Criteria recommend ultrasonography as the initial imaging test for patients presenting with right upper quadrant pain (Table 2).6 Although a meta-analysis of 57 studies from 1978 to 2010 showed that cholescintigraphy has better sensitivity and specificity (96% and 90%, respectively) than ultrasonography (81% and 83%, respectively) for detecting acute cholecystitis,14 ultrasonography is more readily available, can identify other potential causes of pain (Figure 1A), and does not expose the patient to ionizing radiation. I have noticed the pain in the left side stops after a bowel movement but flares up again within an hour or so. It is in my abdomen and down by my hip bone- so more pelvic I guess. Computed tomography (CT scan or CAT scan) is a noninvasive diagnostic imaging procedure that uses a combination of X-rays and computer technology to produce horizontal, or axial, images (often called slices) of the body. If the patient presented for pain in the right lower abdomen or around the belly button, and after going home the pain continues to worsen (or is accompanied by the symptoms mentioned above) then they must please pay attention to their clinicians warning and come back for re-evaluation. An abdominal computed tomography (CT) scan can help diagnose cancer, such as: cancer in the uterus or renal pelvis. Diabetic patient given dextrose, develops compartment syndrome of the forearm. I have had acute abdominal pain since April 2011 and it has escalated over the months.. melanoma. Notes on Normal tests but still have upper abdominal pain? This exam can also be used to find out if you have constipation. The process will likely start with a medical history and physical exam. CT and Xray shows nothing. Most people are familiar with how ultrasounds are used in pregnancy. Doctors may use an abdominal CT scan to look for signs of injury, infection . Nothing picked up on the CT or PET. I wonder if simple documentation stating that the patient was told to avoid aspirin, take a PPI and follow up with GI would have been enough to save this attending from a lawsuit, regardless of whether or not the duodenum perforates. The risk of a negative outcome for a developing embryo or fetus exposed to a single CT of the abdomen and pelvis is very low.26 The ACR practice parameter regarding the use of imaging with ionizing radiation in pregnant patients outlines the specific risks based on gestational age, and emphasizes the importance of obtaining informed consent from the patient before imaging is performed.26. You'll need to have every communication you make about the case available to turn over to the opposing attorney. I have pain on both my sides in my upper abdomen but its worse on the right side. I have been for all the tests MRI, CT, HIDA, endoscopdy, colonoscopy, ultrasound, blood works etc etc and they have all come back clear yet the pain is getting worse as the year as went on and still going. The liver can be damaged in many ways. If your test is ordered stat, then it will be read quickly, usually in under an hour. This condition is extremely painful and can lead to hospitalization. The appendix is a finger like pouch that comes off the large intestine in the right lower abdomen. The peritoneum gets infected by bacteria, fungi, or other irritants, leading to a painful and life-threatening condition known as peritonitis. If the pain advances to the point that standard, over the counter medications, are ineffective, we hope the patient will seek urgent re-evaluation at their nearest ED. If a patients symptoms are suggestive of inflammatory bowel disease, for example, we may provide a referral to a gastroenterologist, who can perform a colonoscopy for evaluation. While these tests are designed to efficiently and accurately identify abdominal and pelvic emergencies, the list of non-life-threatening diagnoses that can cause pain is much longer, and unfortunately requires specialists and testing that we do not have in the ED. foods that you eat. 5 days ago 51 Replies. One of the most common conclusions I reach when I see an abdominal CT scan for abdominal pain is a normal study. Our mission is to help you understand your radiology reports by explaining complex medical terms in plain English. My pain started on my right side first and then evolved too. The only thing I don't have is a burning sensation in my throat. The camera allows a trained physician to view the inside of the esophagus, stomach, and duodenum (the first part of the small intestine). Also see if having a non or low fat diet helps, good luck, Ive had a scan done/ blood work done and also a brath test and it all cam back clear. Everything comes back normal, gallbladder seems - Answered by a verified Endocrinologist . A coordinator will follow up to see if Mayo Clinic is right for you. Constant Abdominal Pain Is Not Easy To Diagnose, Stomach cramps and abdominal pain in early pregnancy, Migraine headache diagnosed with head CT scan, Lower back pain and strong abdominal muscles. All rights reserved. Yes, CT scans can detect diverticulosis. Rochelle Collins, DO, is a board-certified family medicine doctor currently practicing in Bloomfield, Connecticut. Although the patient history, physical examination, and laboratory test results can narrow the differential diagnosis, imaging is often required for definitive diagnosis and treatment. Like the CT scan, it allows images of the body to be made without touching the body directly. Use of the forums is subject to our Terms of Use i have similar symptoms too. The differential diagnosis for abdominal pain is broad, encompassing gastrointestinal, gynecologic, urologic, vascular, and musculoskeletal conditions. Results did not show any emergency findings. Mendelson R. Diagnostic tests: Imaging for chronic abdominal pain in adults. If you take too much of certain medications, drink too much alcohol, or have a health condition affecting your liver, you may have abdominal pain. 2023 Dotdash Media, Inc. All rights reserved. I am thinking of going to the Mayo Clinic but don't know what tests they would do. An ultrasound can often detect problems with the gallbladder and kidneys. For example, studies have evaluated ultrasonography as the initial imaging modality for suspected appendicitis, using CT only if the ultrasonography results are inconclusive or negative. What Are Possible Reasons For Unexplained Stomach Pain? CT is typically the imaging modality of choice if there is significant concern for serious pathology or if the diagnosis is unclear from history, physical examination, and laboratory testing (Table 5).3 A prospective study of 584 patients with nontraumatic abdominal pain in an emergency department setting found that CT results altered the leading diagnosis in 49% of patients and changed the management plan in 42% of patients.20, Conventional radiography is widely available in the ambulatory setting and is often the initial imaging test for evaluation of outpatients with abdominal pain.