Primigravida with right lower chest and right upper abdomen | Figure 1

Case Summary

Patient Details:
34 year old Female, Primigravida, 22 weeks POG complaining of right lower chest pain and right upper abdomen pain for 2 months, initially mild and now moderate to severe.

Symptoms:

• No history of breathing difficulty, cough.
• No relation with food.
• No aggravating or relieving factor.
• No history of loss of appetite.

Investigation Results:

• Ultrasound of abdomen: normal.
• Liver Function Tests:
  • AST: 50
  • ALT: 58
  • Rest within normal limits.

Physical Examination:

• Afebrile, Pulse rate: 80 bpm, Blood Pressure: 110/70 mmHg.
• Respiratory System: B/L equal air entry, no added sounds.
• Tenderness on right lower ribs.

Current Treatment:
Prescribed by Gynecologist: Pantoprazole, antacid, and paracetamol SOS for pain; no relief observed.

Request for Inputs

Kindly provide your valuable inputs regarding possible causes of this pain in the 2nd trimester of pregnancy and management.