24 year old female mother of two. Tuesday I was hit in the body and R arm by an elderly resident. Took my breath away but didn t bother me too much. Tuesday afternoon my stomach felt really gassy and bloated. I hadn t gone since Monday or Sunday (couldn t remember) so I took 2 senna-s to see if that would do the job. Nothing happened. Wednesday I had bilateral flank pain and by noon I could barely stand with pain from right under my chest to my pelvis that wrapped around my whole midsection so that my sides and back hurt severely too. Had blood drawn, all normal on a CMP, CBC, and liver panel except my total bilirubin was 1.4. No fever or anything. I tried 2 suppositories and never went. Thursday I remained in pain, never ate, and tried an enema, never went. Today I couldn t take it, tried an entire 10mls of mag citrate and nothing came. I went to the er. Labs now show bilirubin 2.5. I also have keytones in my urine at 20, I assume from not eating for a couple days. They saw nothing in the xray. I ve developed nausea and a headache today but still no fever. They sent me home with zofran and bentyl. What the heck would cause my bilirubin to elevate and no stool if not a blockage causing stress to the gall bladder? Could she have hit me hard enough to cause this?
In a trauma conjugated bilirubin can be elevated in case of hematomas. Constipation may be explained even as a post-traumatic reaction and exacerbated by painkillers. Next time you should have direct and indirect bilirubin and ALP and GGT in your analysis to know more.