View Full Version : Un-known lower right quadrant abdominal pain

10-16-2013, 07:01 PM
Hello health boards world I am a sixteen year old girl and I live in Brooklyn New York. For a little over a month I've been having constant severe abdominal pain in the lower right side. I forget what it feels like to be out of pain and so far the only thing that has helped are narcotics, and obviously that isn't a permanent situation. I've been to the emergency room several times with this pain and I've been hospitalized twice and currently in my second hospitalization I haven't had a break in 50 days and the doctors still haven't found a diagnosis they've done ultrasounds a head and abdominal MRI a catskan and a colonoscopy and endoscopy. This is medically proved real pain and several doctors have told me they think there is something wrong and they just can't find it. Other symptoms I experience are mild heartburn blood when I use the bathroom and mild lower right back pain. A month ago they found mesenteric-lymphadenitis but they say its gone now. I need help I am tired of pain and having no relief please if any one out there can help me please! I really need answers and I need a solution

10-19-2013, 10:55 PM
Have you had your appendix removed?

10-19-2013, 11:19 PM
I would consider Crohn's disease and lupus 2 top suspects. The mesenteric lymphadenitis could be associated with either, and lupus could cause peritonitis, an inflammation of the lining of the abdomen, which causes severe pain similar to appendicitis. Have you had any abnormal blood tests? I'll bet they haven't checked an ANA for lupus. Have you had a sed rate and CRP? Was there any sign of inflammation in the cecum, where Crohn's inflammation usually starts? That would show up on MRI of abdomen. Any fever or diarrhea? Interstitial cystitis can cause blood in urine without infection, and can cause bladder pain, frequent urination, and can occur in lupus. I would ask your Dr about those 2 things, and try to get a copy of ALL your test results from hospital, going over each to see any abnormals, and look for an ANA test, sedimentation rate (ESR) and CRP, inflammation markers. You can post any results if you'd like or need feedback to understand.

10-20-2013, 05:00 AM
No I haven't and my last imaging was three weeks ago so I wonder if the mesenteric-lymphadenitis caused chronic appendicitis

10-20-2013, 08:54 AM
Mesenteric lymphadenitis is an inflammation/swelling of the lymph nodes in the mesentery, a thin clear membrane filled with blood vessels and lymph nodes that ties the small bowel loops together. Lymphadenitis can be a reaction to infection or inflammation in the small bowel (like Crohn's or appendicitis) or can be a primary lymph inflammation, like in connective tissue disease such as lupus. It is highly doubtful that an inflamed appendix would defy diagnosis or last this long without declaring itself by getting worse. I think this has to be something more subtle, more insidious, and out of the ordinary usual suspects. The inflammatory markers (sed rate and CRP) are helpful clues but non specific. Peritonitis, such as occurs in lupus, causes rebound tenderness (hurts worse when pressure applied to the abdomen is suddenly released) or when abdominal contents are jarred, like riding in a car over bumpy road or sitting down too hard and fast in a chair. The anti-inflammatory meds like Naproxen (OTC) can help that type of pain. Crohn's can show up on a CT scan or small bowel follow-thru xray. I would highly recommend you get the written reports from your imaging studies to look for mention of inflammation, swelling (edema) in the RLQ. A cystoscopy may be helpful to rule out interstitial cystitis, since you have urinary symptoms without apparent infection.