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Dr. Phil, MD
Dr. Phil, MD, Medical Doctor
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Experience:  Medical Doctor Trained at a Top Academic Institution
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pain under left rib,/top of abdomen, feels like a lump under

Customer Question

pain under left rib,/top of abdomen, feels like a lump under my rib especially when I bend or sit down or lie on it at night. It itches sometimes but no rash. a full blood profile said everything normal as did stool, urine sample
Submitted: 2 years ago.
Category: Medical
Expert:  911DOC replied 2 years ago.

911DOC :

Hello and welcome to JustAnswer,

911DOC :

curious indeed.

911DOC :

wouldn't expect to learn anything about this from blood work or stool or urine.

911DOC :

would expect that a chest xray would be a good place to start followed by a CT Scan of the lower chest/ abdomen and pelvis....

911DOC :

are those coming up for you?

911DOC :

and how about an endoscopy where a Gastroenterologist looks down into the stomach with a video camera?

911DOC :

could be an abdominal wall hernia especially if you have had prior abdominal surgery

911DOC :

these can come and go and do tend to be positional

Expert:  911DOC replied 2 years ago.
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Expert:  911DOC replied 2 years ago.

i did not see you in the chat.

 

my suggestions for you are as follows and based on the fact that you can actually feel something there under the rib. if you can feel something, something is there, and imaging studies are what is needed and they would include, depending on the exam your physician does....

 

1. an ultrasound of the area to see if a hernia can be identified or a soft tissue mass

2. a CT scan with contrast through the area

 

one or both of these would identify this lump or nodule, and depending on where it was located and other characteristics of the findings a surgeon might need to do a biopsy either with a fine needle or with a surgical procedure under anesthesia.

 

the left upper quadrant of the abdomen contains the stomach and spleen and this is also the lower portion of the rib cage so there's not too much here that is worrisome from my perspective, but a nodule or lump anywhere that is new and causing symptoms needs to be investigated and diagnosed. they are, occasionally, dangerous, and, occasionally, indicative of other problems which are not obvious from the symptoms.

 

I am standing by if you have any questions.

 

Best

Customer: replied 2 years ago.
Relist: Other.
no reply about the itching
Expert:  Dr. Phil, MD replied 2 years ago.

Hello. I would like to help you find an answer.

 

Are you taking any medications?

Customer: replied 2 years ago.
lansoprazole, livial arthrotec occasionally. lansoprazole is very recent
Expert:  Dr. Phil, MD replied 2 years ago.
Could the itching be related to this medicine?
Customer: replied 2 years ago.
no, I have had arthrotec on and off since an injury in 2003 and livial since 2000 following a hysterectomy. The itching is over the pain area and i am terrified it's some sort of cancer. my gp gave me lansoprazole in the hope it was stomach acid but i have no heartburn or nausea
Expert:  Dr. Phil, MD replied 2 years ago.

Okay.

 

My recommendation would be to get an ultrasound of that area to look for anything suspicious.

 

I highly doubt cancer though.

Customer: replied 2 years ago.
have had ultrasound scan. spleen, liver , gall bladder all ok but pain is still there and when I bend over it feels like an obstruction. Doc said he would not be able to see hernia. pain is worse after eating and today has travelled to back and side as well
Expert:  Dr. Phil, MD replied 2 years ago.

Okay. You need to have a HIDA scan.

 

It checks functionality of gall bladder. Gall bladder can not be pumping properly even if ultrasound is normal.

 

It's called biliary dyskinesia.

 

Thanks. Please accept.

Customer: replied 2 years ago.
pain is on opposite side to gall bladder. what makes you think it is not pumping
Expert:  Dr. Phil, MD replied 2 years ago.

Pain after eating is a cardinal sign of gall bladder issues.

 

Could also be the stomach. You need a HIDA scan and an endoscopy.

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