Ask a doctor on the topic of Internal medicine

Unexplained abdominal pain

March 15, 2012 | 20,00 EUR | answered by Dr. med. Ralf Berg

I am 55 years old and have the following symptoms:
- Recurring pain on the left side of the abdomen for about 3 years, mainly at a specific spot near the hip bone or groin area
- Pain is not related to eating, deep-seated, and pressing
- Constant pain for about 6 months (pain scale about 4-6)
- Sudden increase in pain without apparent reason (even at rest) within 1-2 hours, then strongest pain (pain scale 10), as if something is trapped, severe limitations in movement, lasting for 3 to 4 days, followed by slight improvement
- Treatment with tablets (Diclac 75), ointments (Voltaren) and ice packs, with moderate success, heat usually worsens the pain
The following tests have already been carried out:
- Abdominal ultrasound
- Stool examination
- Complete blood count (no inflammation) (02/2012)
- Abdominal CT scan (06/2011)
- Liver MRI (05/2009)
- Urologist examination of kidneys and bladder (urine), prostate (07/2011)
- Colonoscopy (07/2011)
All results were normal.
Then treated by an orthopedist, suspected myalgia of the inner lumbar muscle, already underwent 12 manual therapies, symptoms worsened.
I have neither stress nor psychological pressure. Occupation: factory work
Pre-existing conditions: pulmonary embolism (taking Falithrom); gallbladder removal.
As my condition has worsened in recent months without any doctor being able to help me so far, are there any other ideas for the cause or treatment options?
I sincerely thank you in advance for a response.

Dr. med. Ralf Berg

Dear patient,

good advice is hard to come by. In principle, the region and all organs that could be responsible for these complaints have been examined with different methods.
Another possibility could be so-called adhesions = adhesions that can occur after inflammatory bowel attacks and restrict the free movement of the loops of the small intestine. Your episodic complaints without an external cause would fit well with this. Unfortunately, these sometimes very small adhesions can hardly be seen from the outside (not even in an MRI).
If I were in your place, I would now consider an exploratory laparotomy. This is an operation in which the abdominal cavity is directly examined by the surgeon with an endoscope in order to see if there is a reason (e.g. an adhesion) for your complaints. Smaller adhesions can then be released in the same session.

Best regards Dr. R. Berg