I have been having severe upper right pain right under my ribs for about 2 months now. I also have nausea as well. Cat scan, ultrasound and blood work all have came back normal. Had a hida scan done I had pain with the cck injection. Says it's functioning at 76 percent. Is that normal? abnormal? What is the next step? I am on tramadol for pain an protonix for nausea.
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replied June 13th, 2014
Welcome to ehealth forum.

Patients with disabling right upper quadrant pain, a normal abdominal ultrasound, and normal liver tests, amylase, and lipase might have gallbladder disorder.

A gallbladder (HIDA) scan is a nuclear scanning test that is done to check gallbladder function. The scan can find blockage in the tubes (bile ducts) that lead from the liver to the gallbladder and small intestine (duodenum). If the gallbladder ejection fraction is <40 percent it is a indicator of gall bladder disorder.

In case the ultrasound is normal, then the condition is called a functional GB disorder.

In your case, with symptoms of typical gall bladder dysfunction (as mentioned above) and all tests (including Liver functions, ultrasound & the HIDA scan) found normal, possible diagnosis include -

1. Sphincter of oddi dysfunction (SOD) or
2. Normokinetic biliary dyskinesia.

The sphincter of Oddi is a sphincter muscle, a circular band of muscle at the bottom of the biliary tree which controls the flow of pancreatic juices and bile into the second part of the duodenum.

SOD occurs due to either narrowing of the sphincter or as a result of abnormal contraction of the sphincter (termed biliary dyskinesia)

The condition can be diagnosed by a manometry test, which determines whether or not the sphinter muscle is functioning normally.

Treatment of the condition can be either with antispasmodic medications or surgery (sphincterotomy) to remove part of the sphinter and hence reduce the contractility.

The treatment in most cases of Normokinetic biliary dyskinesia (the 2nd possible cause) is cholecystectomy.

Hence as discussed above, you might consult your treating doctor who can explain your diagnosis and help you decide the future management.

I hope the information here is helpful.
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replied January 29th, 2016
Cardiolite Injected for HIDA Scan
I recently went to the hospital for a HIDA SCAN. The technician injected the wrong dye (Cardiolite). There were two bright spots on the monitor, which the technician indicated were not normal and that they represented my kidneys. I had burning and pain in esophagus and pain in the lower right area of my back. What are your thoughts??
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