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Dr. D. Love
Dr. D. Love, Doctor
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Experience:  Family Physician for 10 years; Hospital Medical Director for 10 years.
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Will an abdominal CT scan with contrast show muscles or connective

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Will an abdominal CT scan with contrast show muscles or connective tissue that is inflamed and sore? Starting a few months after a colonoscopy I started experiencing a recurring pain in my left flank, which is aggravated by exertion, such as jogging or bicycling or using a tread mill. My colonoscopist indicates in his notes that there was some difficulty with looping of the scope, and I remember some pain. Saw a GI doctor yester day who denies that the colonoscopy caused the pain, yet referred me for an abdominal CT scan. Will this show otherwise normal tissue that is, now, somehow causing pain. I know this is a rare event, but I cannot seem to make the pain go away, unless I do nothing at all and take a tylenol. I'd like to get a diagnosis that the pain was caused by the colonoscopy, rare though it may be.
Submitted: 3 years ago.
Category: Medical
Expert:  Dr. D. Love replied 3 years ago.

A CT scan does not indicate tissue that is causing pain, but it can show tissue that is inflamed, because inflamed tissue tends to be swollen, which is able to be seen on the CT scan. There needs to be a certain amount of swelling to be detected by a CT scan, so it may not detect mild inflammation. There is also certain tissue that is not seen well by a CT scan, but it will detect many areas of inflammation.

 

I would also note that the fact that this symptom did not start until a few months would make it even less likely that it was due to the colonoscopy. In the rare situations in which colonoscopy does cause pain such as you describe, the pain typically starts much sooner after the colonoscopy.

 

Customer: replied 3 years ago.
"In the rare situations in which colonoscopy does cause pain such as you describe, the pain typically starts much sooner after the colonoscopy."

I know that is true. That's why I said this was very rare. The GI doctor yesterday said it wasn't caused by the procedure. The prob. is I was not doing anything in the interim that would have caused a typical muscle pain, this is not like any muscular pain I have had before---in ANY respects I can think of, and be;lieve e I have had plenty of sore muscles. And I did see some articles that said these pains can start much later. I think the initial inflammation in this type of injury may send endorphins out that mask the pain for awhile. This is very weird, and I don't like to make a case where there isn't one. But with this persistence (20 mos) the oddness of the feeling, and the fact that it is on my left side where mesenteric damage is more likely to occur makes it seem like a real possibility. One rare complication is tearing of the outer membrane of the spleen, but before that the splenic-colic ligament can be stretched, and I have read that mesentery tissue can be stretched and injured. So I think that is what happened to me. I don't think I have anything like actual spleen damage or laceration of the mucosa---but there are significant abnormalities in >10% of exams, so I'm probabbly in the .001 that has some kind of chronic pain that is not life threatening but still a pain in the --s.
Expert:  Dr. D. Love replied 3 years ago.

There is significant variability int eh length of the mesentery, so a CT scan would not detect stretching of the mesentery, but it would detect inflammation, as noted above.

 

Customer: replied 3 years ago.
Would inflammation last for a long period of time past the time of injury? Or, could it be gone, and the pain resulting from scarring? I always think of the term "old war wound" because that is what this pain is like. It goes away for awhile, returns for awhile, but is always aggravated by more intense exertion. It moves all over my left flank, sometimes beuing a sharp pain in front, sometimes being a dull ache in the back. But it follows the path of the splenic flexure, and remains month after month; so that is what makes me think it is relate to the colonoscopy; phy. notes described "significant looping" and I remember yelping four times. Do you have any recommendation to what type of physician or specialist I should see? It is stopped when I take an oxycodone 5 mg., but I don't want to do that. I've thought of getting an infrared machine since this is deeper than the ab muscles. This is really cutting into my activity level. Thanks. I think this is my last question.
Expert:  Dr. D. Love replied 3 years ago.

There are certain situations in which inflammation can persist. Pain can occur from scarring, but most scarring is too small for a CT scan to detect. The appropriate specialist to evaluate persistent pain in the abdomen is a Gastroenterologist, although you might want to consider seeing a different Gastroenterologist to get an unbiased opinion.

 

Dr. D. Love, Doctor
Category: Medical
Satisfied Customers: 13549
Experience: Family Physician for 10 years; Hospital Medical Director for 10 years.
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