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Ask Dr. Gupta Your Own Question
Dr. Gupta
Dr. Gupta, Doctor (MD)
Category: Health
Satisfied Customers: 8048
Experience:  Vastly experienced MD Physician with 19 years of experience.
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I recently had a ivp the pictures show I have a metal

Customer Question

I recently had a ivp the pictures show I have a metal surgical clips located near where my gull bladder was. I have also a single clip that is new my 4 and 5th lumbar. I had my appendix remove 20 years ago. Noone can say why the clip is near my 4th and 5th lumber. I believe the clip migrated from my gull bladder surgury. I want to confirm is clips are used and left in in appendectomies. I am in alot of pain and have had many procedures that rule out my stomache. After all this time the xray from my IVP has me wondering what is really causing my discomfort
Submitted: 10 years ago.
Category: Health
Expert:  Family Physician replied 10 years ago.
surgical clips are used in all kinds of surgery including appendectomies. It would NOT be uncommon to find such a clip on an X-ray
Customer: replied 10 years ago.
Then why so much pain especially where my gull bladder was removed.
Expert:  Family Physician replied 10 years ago.
The pain could be related to scar tissue or even a stone in the common bile duct. I would suggest talking with your doctor about getting some additional tests - such as an ultrasound. They may also need to consider an ERCP (a test where they inject dye into the common bile duct to rule out any obstruction)

Other things that can cause pain in the right upper quadrant - a stomach/duodenal ulcer.
Customer: replied 10 years ago.
Reply to Family Physician's Post: I find it very harad to agree to the clip not being from my gull bladder. My appendectomy was 20 years ago. Your saying 20 years later the clips used are the same.
Expert:  Family Physician replied 10 years ago.
I will be glad to ask someone to give you a second opinion.
Expert:  Dr. Gupta replied 10 years ago.
Family physician has asked to offer my opinion.
Gall bladder surgery also involves the placement clips (generally metal- titanium clips). This is a normal thing and a matter of routine should NOT lead to any symptoms.
Rarely you may get symptoms that are due to the clips, causes may include clip related obstructions, ? allergy to clips etc. I mus state that this would be a very rare case indeed.
Please get yourself evaluated again after reading this particular link

Customer: replied 10 years ago.
Reply to Family Physician's Post: I have had an upper GI and and endoscopy that came back with no evidence of an ulcer. You mentioned a possible stomache/duadenal ulcer. Would that be visible or detectable with the upper GI or endoscopy. What is a stomache/ duadeanl ulcer? Please note I have some pain all the time. Sometimes feels like a pin is pricking me in the upper right back quadrant. The worst pain has been in the front upper right. I do feel some foods cause greater irritation. But not always. But,for the most part there is sensation all the time.
Customer: replied 10 years ago.
With Gull bladder removed could there be a stone in the common bile duct?
Expert:  Dr. Gupta replied 10 years ago.
Let me try to answer these questions for you,
Normally and Upper GI endoscopy should pick up a stomach ulcer, and possibly a duodenal ulcer too.
A common bile duct stone can be present even after Gall bladder surgery, and as suggested previously, a specific procedure called the ERCP will help in diagnosis of this condition,
I believe that your pain could be related to the metal clips also ...though the chance is less likely. Only further investigations will lead to resolution of your problem,