Very interesting and difficult case. Young adult female, 6 year history of intolerable stabbing / burning pain located retrosternally. Pain increases with bending over or after consumption of fatty foods. Also present are frequent violent hiccups and retching episodes that also intensify pain; these episodes can also be triggered by palpation of the right side of the neck. Pain has thusfar only responded to high doses of codeine. Patient is also consistently fatigued and sleeps 12-15 hours. She does snore loudly but does not appear to stop breathing. Fibromyalgia, oesophageal abnormalities and heart problems all ruled out by rheumatologists, gastroenterologists and cardiologists respectively. What are your thoughts?
Gall bladder diseases? đ¤ pain triggered after fatty meal and hiccups which could be due to the irritation of the diaphragm
My first thoughts would be cholecystitis, but along with that her bile duct may be quite blocked as well, therefore adding to those areas of pain.
All clear by cardiologists. Currently investigating neurological possibilities at rare disease centre.
