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Q. Will my abdominal pain after cholecystectomy throw me into SVT?

Answered by
Dr. Mashfika N Alam
and medically reviewed by iCliniq medical review team.
This is a premium question & answer published on Oct 21, 2018

Hello doctor,

I am 29 years old male, 5'7", 235 lbs. I am suffering from SVT, degenerative disc L4 to S1, ulcerative colitis. Have undergone appendectomy (more than 10 years ago), tonsillectomy (more than 10 years ago), cholecystectomy (three years back). Medicines I am taking are Lopressor 50 mg twice daily, Norco 10 mg (as needed), Bentyl 20 mg. For the last three days, I have been having severe abdominal pain. Similar pain as when I had gallbladder attacks. Started out as come and go thing. But all day has been constant. I had also been vomiting. At least six times today. Not able to keep any medicines down or food or liquids.

For the last few hours now I have been having episodes of SVT. Not lasting longer than 20 minutes and the maximum rate was 210. However, I have been able to vagal down each time. I am currently at the normal rate but my BP is high (176/110). Can my abdominal pain throw me into SVT? I have not had an episode like this in quite a while. Usually well controlled. Mostly my concern is with the abdominal pain as this is very painful and becoming intolerable.

#

Hi,

Welcome to icliniq.com.

Your symptoms are most likely a classic case of post cholesystectomy syndrome which occurs roughly after two years post cholecystectomy, like your case. This can be dealt with by dietary modification like fat-restricted diet and oral ursodeoxycholic acid if there are persisting stones. An abdominal ultrasound can identify it. Hepatitis could also be a possibility so do not take Aspirin or any NSAIDs. Antispasmodics can help with the pain. As for SVT (supraventricular tachycardia), anything can set off an attack like stress, exertion. So, in your case, the severity of the pain could be causing it. You need to get both your heart rate and blood pressure down as soon as possible. You might need injection Adenosine. Take an antispasmodic for the right quadrant pain. I understand all these medications require a prescription.


Investigations to be done:

Upper abdominal ultrasound.

Differential diagnosis:

Acute hepatitis.

Probable diagnosis:

Postcholecystectomy syndrome with supraventricular tachycardia.

Treatment plan:

Prescription drugs like a beta blocker or Adenosine, antispasmodic for pain relief, Ursodeoxycholic acid if microlithiasis.

Preventive measures:

Avoid fatty food.


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