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Upper abdominal pain enlarged lymph nodes

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This is quite long and complicated so will try to keep it as brief as possible.

Problems started about 18mths ago - once or two episodes of upper central abdominal pain which was intensive for about 6hrs then completely resolved.

This time last year I had an attack of vomitting and then upper central stomach pain, this time much worse. 2 days later I had my appendix removed via open surgery, they had started to rupture and the tip turned gangerous.

Two months later the upper stomach pain started again. A scan confirmed gallstones. The pain gradually got worse and I had my gallbladder removed in July 2010. I woke up from surgery with a lot of pain - same place. After it was established this was not an incision pain blood tests showed elevated amylase (pancreas) levels (mildly elevated - 230 max). Liver enzymes were extremely elevated - ALT / AST both about 600.

CT scan two days later was clear. MRCP scan in September showed dilated bile duct and I was referred to a pancreas specialist.

Two endoscopic ultrasounds in October and November showed enlarged lymph nodes (lymphadenopathy)surrounding common bile duct and liver. I am not awaiting another CT scan and if lymph nodes still swollen a laparoscopy to remove and analyse them.

Other symptoms include elevated amylase (since surgery in July), occasional floating stools and diarrhea and I've had a low grade fever for 8wks. At the sight of pain my stomach is always hot to touch.

Does anyone have a clue what this could be? The specialist suggested this wasn't due to the surgery and a problem before then (what I thought was gallbladder pain). I'm at my wits end and rather worried - I'm fed up with being told its complex and they aren't sure what the cause is.

Many Thanks
Debbie
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replied December 14th, 2010
Hi,
Welcome to the forum. I am really glad to help you out. I can understand the pain and agony which you're going through. There seems to be some common entity which is blocking the flow of pancreatic and common bile duct resulting in the elevation of the amylase and liver enzymes. This is possibly by the enlarged lymph nodes.

The lymph nodes can get enlarged in a number of conditions like due to some malignancies (tumors) like lymphomas, infections of the gut etc. A biopsy from those or any other enlarged lymph nodes should be able to give the answer to this. It makes sense to do an MRI of the abdomen if the CT has failed to give an answer. I sincerely hope that helps. Take care.


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replied December 14th, 2010
Hi,

Thanks very much for your reply. It does sound like something is blocking the flow somewhere. I originally thought it would be a bile duct injury after the surgery - do you think this is possible? I've had an MRCP scan - would that show the stomach aswell or just bile ducts?

Thanks
Debbie
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replied December 14th, 2010
hi, i never thought i would be writing about this, but i kind of have the same problem, am sorry to hear what debbies got, mine is smiliar to what she has said. am still getting used to this forum and not sure where i am suppose to write. but here is my story.

my stomach ache started like 5 years ago, and everyday i had pain, i have been to so many docs and specialist.
just few months ago i had laproscopic scan done and they found my appendix was bleeding and twisted around some veins, which was causing some pain, so they removed that and cut few tissues here and there which was affected by the appendix.

i thought that would fix the problem but it didnt. my upper abdomen is very sore, it gets worse at times, i saw my doc again and they told me to go on food diet to see if i am allergic to some food, and i am now taking gastric tablets and another few ones. but my pain is mostly focused around where my tummy is and it gets very hard at one spot.

would anyone have a clue of what it could be.

thank you
renu
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