CONSULTATION

Patient Name
Victor Peterson

Patient ID
973577

Consultant
Mary Wells, MD, Gastroenterology Services

Requesting Physician
Erik Lunderman, MD, Pulmonary/ Respiratory Services

Date of Consult
10/16/2018

Reason for Consultation

Please evaluate RUQ abdominal pain

HISTORY
This patient, a 58-year-old male, being seen at the request of his
pulmonary/respiratory physician on Friday, October 16, has been admitted
to the hospital for elective thoracotomy and decortication for suspected
mesothelioma. The patient has a long history of asbestos exposure, having
difficulty with shoulder and arm pain, with the diagnosis of mesothelioma.
Two days ago he developed right upper quadrant abdominal pain. The
patient has never experienced this type of discomfort; he has had no history
of acid peptic disease, no known cholelithiasis. He denies fever, chills,
hematuria, dysuria, or frequency.

PHYSICAL EXAMINATION
The exam being done at this time is limited to the abdomen where bowel
sounds are present and normal. There are no discrete masses felt. There is
fullness in the right upper quadrant, and the patient does exhibit some
minimal tenderness to palpation in the right upper quadrant. The patient has
been afebrile. Ultrasound of the gallbladder does show cholelithiasis with a
borderline common duct.

DISCUSSION
At the present time the patient is known to have stones. I suspect his
discomfort is from either an episode of cholecystitis or choledocholithiasis.
CONSULTATION

Patient Name: Victor Peterson

Patient ID: 973577
Date of Consultation: 10/16/2018
Page 2
I would suspect that liver function studies may be helpful in suggesting the
presence of choledocholithiasis. We will make arrangements for the LFTs and
possible sphincterotomy.

IMPRESSION
1. Status post resection of mesothelioma
2. Cholelithiasis, rule out choledocholithiasis
Thank you very much for allowing us to participate in the care of your
patient. We will follow him along with you as necessary.

_____________________________
Mary Wells, MD
MW:AC
D: 10/16/2018
T: 10/17/2018