Sunday, May 22, 2011

Recurrence of Abdominal Pain after Cholecystectomy

Gall bladder, German and LatinImage via WikipediaCholecystectomy, removal of gall bladder may be performed in certain diseases of gall bladder; commonest amongst those is cholecystitis or inflammation of gall bladder.
In cholecystitis, pain is felt in the right upper abdomen; either in the middle or to the right side. The pain may simultaneously be felt in the angle of right scapula, the shoulder blade bone and/or in the shoulder. There is catching of breath while the gall bladder site is pressed in the abdomen called Murphy’s sign.
In some patients the pain may persist even after removal of gall bladder, or Cholecystectomy.
There can be certain reasons for it or may not have any possible explanation, when it is termed as post-cholecystectomy syndrome.
Before labeling it to be post-cholecystectomy syndrome without any cause, certain other things are to be looked into. The conditions which can give rise to such pain can be many, commonest among those are:
· Retained stone in the cystic duct, gall bladder duct.
· Inflammation of gall bladder duct, if long enough had been left behind.
· Inflammation of the part of gall bladder, if some part of gall bladder had been left behind as in case of partial Cholecystectomy in a difficult to remove gall bladder,
· Overlooked stone in the common bile duct.
· Already narrowed opening of the bile duct.
· Some other diseases like peptic ulcer, pancreatitis or stone in the right kidney; if co-existed and overlooked.
After excluding all these causes, an idiopathic post-cholecystectomy syndrome is diagnosed for which no specific treatment exists.
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