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Mrs Mungo
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Any ideas about this?

 

Upper left quadrant of abdomen is tender (cor a couple of days), swollen ( today) and a little hot to the touch (today and not very). No fever on a thermometer. A little bit of stomach upset over the last few days (all kinds). Not a drinker (now you know it is not me, lol!). Wants to put off the ER until the morning. WDYT?

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Feel along the rubbery rib tips. If it is those (you can feel the pain in the upper abdomen, but when you touch those rubbery tips, it causes a yelp) it is probably costrochondritis. It can cause localized swelling.

 

As for the rest: no fever, no diarrhea, no vomiting, no nausea, no constitutional symptoms, no sense of impending doom, and it doesn't look worse than a boil coming up, I'd put off the ER, personally. But, I'm really not one to rush there. If s/he/it is ready to go to bed and sleep, I'd follow that lead. Of course, given no history of diabetes or immunocompromise, etc. You aren't miles from help with an ice storm pending, etc.

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Okay this is weird but I was going to post the same thing today but forgot. My 18yo who is away at school told me yesterday she had the same swelling at the same location and she decided it was spleen. She had the flu and now has a lingering bronchitis and is very tired still. She said the pain radiated to her shoulder and was pretty intense for a couple of days but since it was a long weekend and the pain had begun to subside by Tuesday she didn't bother telling me abut it or going to see a doctor. My reason for posting is two-fold...first to ask if any of this sounds familiar to you. She had a tender spleen when she had mono back in 9th grade, so it can be swollen without a lot of pain. This time was much worse with difficulty breathing. I'm seriously upset she didn't mention it to me. it's not like we don't talk. So I hope you don't mind a slight hijack for me to ask Kalanamak whether she should still see a doctor to make sure she has cleared the infection that caused the problem, even though it was a week ago?

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It is below ribs. It is big area swelling-like near the belly button to the hip. I am calling the advice nurse, just in case. We are just about a block from the hospital though. No complications other than a history of GI problems.

 

A rectus muscle bleed? Is this person anti-coagulated? Usually the blood irritates and the person is loath to sit up.

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Okay this is weird but I was going to post the same thing today but forgot. My 18yo who is away at school told me yesterday she had the same swelling at the same location and she decided it was spleen. She had the flu and now has a lingering bronchitis and is very tired still. She said the pain radiated to her shoulder and was pretty intense for a couple of days but since it was a long weekend and the pain had begun to subside by Tuesday she didn't bother telling me abut it or going to see a doctor. My reason for posting is two-fold...first to ask if any of this sounds familiar to you. She had a tender spleen when she had mono back in 9th grade, so it can be swollen without a lot of pain. This time was much worse with difficulty breathing. I'm seriously upset she didn't mention it to me. it's not like we don't talk. So I hope you don't mind a slight hijack for me to ask Kalanamak whether she should still see a doctor to make sure she has cleared the infection that caused the problem, even though it was a week ago?

 

It is possible to have an empyema under the diaphragm like that. Fever tends to come and go.

 

The only time I've felt a spleen as a lump that goes down to the pelvis (hip) is in horrible liver failure and the person is yellow and obviously sick.

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A rectus muscle bleed? Is this person anti-coagulated? Usually the blood irritates and the person is loath to sit up.

 

 

Hey can you take a quick peek at my post upthread and tell me if I should insist Jen see a doctor even though her swelling has gone down and seems to be the mend? She doesn't think so but I worry that she is still fighting a virulent bacterial infection.

 

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It is possible to have an empyema under the diaphragm like that. Fever tends to come and go.

 

The only time I've felt a spleen as a lump that goes down to the pelvis (hip) is in horrible liver failure and the person is yellow and obviously sick.

 

 

Hmm. Don't know if it was an actual lump as mrs mungo is describing. I didn't actually see her when all this was happening.

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Hey can you take a quick peek at my post upthread and tell me if I should insist Jen see a doctor even though her swelling has gone down and seems to be the mend? She doesn't think so but I worry that she is still fighting a virulent bacterial infection.

 

Could also be left lower lobe pneumonia.

But is she eating, improving, has energy, able to sleep, and generally on the mend? Usually pneumonia you feel like death warmed over. No energy, sleep all the time, cough optional.

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Diagnosis: diverticulitis. Should be okay in a few days with a special diet and abx.

 

Wow. That is usually left lower quadrant.

 

BTW, there is MUCH yap about no seeds etc, but that is more just verbally passed dogma. Last time I looked into it there were NO studies showing that sunflower seeds etc get caught in diverticulum and cause diverticulitis. However, the diet is not onerous (and it gives patients a hope there is something they can do to prevent it).

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Wow. That is usually left lower quadrant.

 

BTW, there is MUCH yap about no seeds etc, but that is more just verbally passed dogma. Last time I looked into it there were NO studies showing that sunflower seeds etc get caught in diverticulum and cause diverticulitis. However, the diet is not onerous (and it gives patients a hope there is something they can do to prevent it).

Wow, that is so interesting.

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K-The research I have done on my phone while we wait on meds indicates that there has been no research to back up the idea that seeds and such are to blame. The doctor said the same. For now, it is a clear liquid diet for a couple days, gradually adding back in solid foods to give everything a chance to rest.

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Could also be left lower lobe pneumonia.

But is she eating, improving, has energy, able to sleep, and generally on the mend? Usually pneumonia you feel like death warmed over. No energy, sleep all the time, cough optional.

 

Yeah, this was her back about a week and a half ago. But she is feeling much better. I guess she is clearing whatever it is on her own then.

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Wow. That is usually left lower quadrant.

 

BTW, there is MUCH yap about no seeds etc, but that is more just verbally passed dogma. Last time I looked into it there were NO studies showing that sunflower seeds etc get caught in diverticulum and cause diverticulitis. However, the diet is not onerous (and it gives patients a hope there is something they can do to prevent it).

 

 

Aha, so that's the name it. Growing up, I was told by older folks not to eat the seeds inside the tomato because it could cause those sorts of symptoms. To this day, those voices still are reprimanding me each time I cut open tomatoes.

 

 

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