Navigating Conflicting Information on Cholecystitis Diagnosis
Background Information: Age 29, Height 5'11", Weight 285 lbs, generally out of shape, occasional light alcohol consumption, non-smoker, currently taking 200 mg of Sertraline and Quetiapine daily. Symptoms: Over the last 12-18 months, I have experienced abdominal pain approximately 4-6 times. This pain is described as crampy and gnawing, akin to hunger pangs, at times feeling as though my abdomen might burst. The discomfort is mainly centered about an inch above my navel, accompanied by slight stomach distension. The episodes usually last around 6-8 hours, and I have had recent bouts of diarrhea. Absence of Symptoms: I would like to clarify that I have NOT experienced nausea, vomiting, fever, sweats, or pain radiating to my lower back. Incident Timeline: - **August 24:** - 6 PM: Consumed a Chipotle bowl with chips and guacamole. - 10 PM: Tried to sleep but discomfort prevented it. - **August 25:** - 4 AM: After a sleepless night, I decided to go to work early. - 4:30 AM: Found it difficult to remain still at work due to discomfort; drove myself to urgent care. There, I received hydration via an IV (2L saline, 1 bag of acetaminophen, and 1 bag of antibiotics over two hours). - 5 AM: Underwent blood testing, a urinalysis, and a CT scan. The results indicated an inflamed gallbladder, leading to a diagnosis of acute cholecystitis and an incarcerated umbilical hernia. A significantly elevated white blood cell count was prevalent. The doctor advised me to schedule a follow-up with a primary care physician (PCP) for further evaluations and a possible surgical referral. Prescriptions included Clindamycin (300 mg four times a day) and Tramadol (50 mg as needed). - **August 26:** - 7 PM: Ate a Salata wrap. - 10 PM: Experienced the same pain as previously, took Tramadol which provided relief, allowing me to sleep. - **August 27:** - 4 AM: Woke up due to pain; took Tramadol and fell back asleep. - Noticed very dark stool (not tarry) and bright orange urine on this day, wondering if it might be a side effect of the medication. - **August 29:** - Saw a PCP who agreed with the diagnosis of acute cholecystitis and confirmed the presence of a visible hernia, but disputed the incarceration classification. She suggested scheduling a visit with a surgeon, noting that I was protective during the abdominal examination. - **September 4:** - Consulted with a surgeon, who confirmed the symptoms matched the acute cholecystitis diagnosis. He stated the hernia was present but defined it as fat, not intestine. He recommended an ultrasound for thorough evaluation and planned a cholecystectomy for September 9. - **September 5:** - Underwent an ultrasound where the technician observed that the gallbladder appeared normal, with no gallstones present. There was also no inflammation or thickening of the walls. The technician seemed puzzled by my diagnosis since I reported pain in the mid-abdomen rather than the upper right quadrant and felt no discomfort during the gallbladder examination. Current Situation: I find myself uncertain about proceeding with surgery, especially given the absence of abnormalities in the ultrasound results. I am keen to avoid unnecessary surgery. I anticipated the ultrasound would reveal some issues, but the technician’s findings and confusion regarding my pain’s location have raised my doubts. Three professionals recommended the gallbladder removal, while one expressed caution. Asking for Insights: Do my symptoms align with the diagnosis of acute cholecystitis? I haven’t exhibited the typical signs associated with gallbladder issues, which leaves me perplexed. While the CT findings seemed conclusive, the ultrasound results have shaken my confidence. I have my medical documentation available if anyone requires further review. Thank you in advance for any insights you can provide.
Answers (1)
9/6/2025, 1:01:51 AM
OpenHealth AI
Your situation involves some complex medical considerations, especially with the conflicting information regarding your diagnosis of acute cholecystitis. It's understandable to feel uncertain about proceeding with surgery when ultrasound results appear normal, and that concern is valid.
Key Points:
- Symptoms vs. Diagnosis: Acute cholecystitis typically presents with right upper quadrant pain, fever, and often includes nausea or vomiting. Your symptoms of mid-abdominal pain and lack of classic signs may raise questions about this diagnosis.
- Diagnostic Conflicts: The CT scan indicated inflammation, while the ultrasound did not show gallstones or gallbladder wall thickening, which complicates the surgical decision-making.
- Surgical Necessity: Surgery may be recommended when there's clear evidence of disease, but conflicting findings can lead to hesitation.
Explanation:
Acute cholecystitis usually results from a blockage of the gallbladder (often by gallstones) leading to inflammation. Your earlier CT scan suggested inflammation, but the subsequent ultrasound may not support that diagnosis. The varying opinions from specialists must be carefully weighed, especially in your case where one physician questioned the diagnosis.
The darker stool and bright orange urine may potentially relate to the medications you’re taking (Clindamycin or Tramadol), but reporting this to your doctor is prudent to rule out any underlying issues related to liver function or bile flow.
Recommended Next Steps:
- Further Evaluation: Schedule further discussions with your surgeon to address your concerns about the conflicting diagnostic results. Ask for the rationale behind their surgical recommendation despite the ultrasound findings.
- Additional Imaging or Tests: Inquire about the possibility of additional imaging (like an MRI or a repeat ultrasound) or tests to clarify your condition before proceeding with surgery.
- Symptom Diary: Keep a symptom diary leading up to your next appointment, noting the nature of your pain, any episodes of discomfort, and any other gastrointestinal symptoms (e.g., stool changes).
- Discuss Alternatives: Explore alternative management options if surgery is not immediately necessary, including medication changes or dietary adjustments to help manage your symptoms.
Final Thoughts:
It’s essential to feel confident and informed about any surgical decision. Open dialogue with your healthcare providers about your symptoms, concerns, and the rationale for any procedures is crucial. Seek clarity and feel empowered to ask follow-up questions based on your experiences and medical documentation. Your health decisions should always align with what feels right for you, supported by relevant evidence.
Related Questions
24M | Unexplained Fainting Incident
**Note:** I previously shared this story, but it was inexplicably removed. I’m a 24-year-old male without any medical diagnosis or prescription medications. While I do consume alcohol occasionally, I hadn’t been drinking before this happened. Around 3 a.m., I got up from bed to use the restroom. As soon as I began to urinate, I suddenly felt a wave of dizziness. The next moment I was aware of was regaining consciousness in the bathtub, startled awake by the sensation of something dripping on me—only to discover it was my own blood. This was my first experience with fainting. When I came to, confusion set in. I was disoriented and couldn’t comprehend why I was being dripped on while in what I thought was my “bed.” Strangely, I also imagined that I was lying on a collection of marbles (which I actually don’t own)—this turned out to be the shattered glass of my shower door lying around me. I’m uncertain whether I lost consciousness first and then fell, or if the fall caused my brief blackout. It took me a few moments to understand why I was in the bathroom at all. I’m not sure how long I was out; I only remember it was around 3 in the morning when I initially got up, and about the same time when I regained consciousness. I dialed 911, and the ambulance arrived promptly. They checked my vitals, performed an EKG and measured my blood sugar, finding nothing unusual. At the emergency room, they repeated the vital checks, conducted a CT scan, drew blood, and took x-rays—yet still no abnormalities were detected. I had several cuts on my face and left arm (curiously, this is the arm that would have been turned away from the door), along with bruising around my ribs. Since the incident, I’ve been suffering from headaches and pain in my ribs. I received stitches on both my face and arm. The nurse suggested I could have stronger pain relief, but I opted for just Toradol. They eventually discharged me, stating, "We’re unsure what caused this, but return if it happens again." What might have triggered such an incident? How can I safeguard against it reoccurring if they remain uncertain about the cause?
Healing Progress Post-GBS: Toe Concerns
I am a 28-year-old male, measuring 5 feet 10 inches and weighing 131 pounds. My current medications include Fomadatine and Zyrtec, prescribed due to my ongoing battle with Chronic Gastritis and SIBO. I maintain a healthy lifestyle, abstaining from both smoking and alcohol. My health concern revolves around the toe adjacent to my pinky toe on my left foot, as well as my pinky toe on the right foot. Since August of last year, I have been on the mend from Guillain Barre Syndrome. Recently, I've noticed that at night, the skin on my feet tends to turn a reddish pink, although this usually improves after I walk around. However, two of my toes have remained red, with one appearing slightly swollen. Generally, my pinky toes are quite thick, but the condition of my left foot's toe is worrisome for me. It seems that I'm unable to upload an image to illustrate my issue.
Swelling Beneath My Chin Near the Jawline
18-Year-Old Male: I'm reaching out to any medical professionals who might provide insights into my situation. I've been using marijuana since I was 14, but now, at 17, I'm making an effort to stop and have been clean for 18 days. Recently, I've discovered an unusual swelling located just beneath my chin, behind my jaw. It causes some discomfort when I move, yet it doesn’t feel painful continuously. I'm somewhat anxious that this could be indicative of a more serious issue, especially considering it's positioned near my chin's lymph nodes. Any advice or information would be greatly appreciated as it might help alleviate my worry.
Challenges with Appetite and Discomfort While Eating — Difficulty in Gaining Weight
As an 18-year-old male, I find that I become satisfied after consuming rather minimal amounts of food. This situation presents a considerable challenge, particularly since I only need to have a standard breakfast, lunch, or dinner to feel completely satiated for the remainder of the day. My goal of increasing my weight has made this issue even more complicated. When I limit myself to one meal per day, I often face weight loss or an uncomfortable sensation of fullness that leaves me feeling sluggish. Opting for two meals makes me feel excessively bloated, distracting me from my daily responsibilities. Moreover, I suffer from an unusual issue with my throat, where almost any food I consume causes discomfort, as detailed in the list below. I have contemplated focusing on having just lunch while continuing my weightlifting regimen to maintain my current weight and gradually build muscle. What advice could you offer? Could there be an underlying cause for these symptoms? Lastly, would it be wise for me to consult a healthcare professional? Foods That Cause Discomfort: Bread, flour, pizza, fruits, sugary or starchy items, seed oils, chips, and essentially everything else. Foods That Are Tolerable: Rice, salads, chicken, fish, and vegetables. Overall Symptoms Include: * Quick satiety after normal meals * Challenges in gaining weight * Bloated and lethargic sensations when consuming more than one meal * Persistent throat sensitivity to a wide variety of foods
Should I Seek Medical Attention for Left Ear Pulsatile Tinnitus?
A 31-year-old woman reports an ongoing issue with pulsatile tinnitus, which she is currently experiencing solely in her left ear. Although she's noticed this condition intermittently before, she hadn’t paid it much mind due to the absence of pain. Recently, however, her curiosity piqued her interest in researching the condition, where she stumbled upon information suggesting it could be serious. Usually, she avoids searching online for health worries, but now she is contemplating whether a visit to the doctor might be warranted. Can anyone advise on the need for a medical evaluation in this case?