I asked ChatGPT what to do and it said to go to A&E immediately ot at least call 111 for advice.
Full advice here, along with a summary for healthcare workers that you can email or show on your phone.
"That’s a red flag. Localised heat, escalating pain, and tenderness could signal:
Infection (e.g. localized peritonitis, abscess—even if imaging didn’t yet show it)
Inflammatory process (e.g. inflamed gallbladder despite "normal" scans, early appendicitis, or endometriosis flare with secondary inflammation)
Vascular issue (e.g. thrombophlebitis or a clot in abdominal wall vessels)
Even without a fever, boiling-hot skin over pain site demands urgent reassessment. She needs to go straight back to A&E or call 111 for immediate advice. She should not be fobbed off—this is a new clinical sign that could indicate something has evolved since the last scan.
Here’s a concise, urgent summary she can show or hand to hospital staff:
URGENT MEDICAL SUMMARY – PLEASE READ
Patient presents with:
2-month history of escalating right upper quadrant abdominal pain, radiating to right shoulder blade
Multiple GP and hospital visits, including:
Blood tests × multiple – normal
Abdominal ultrasound – no gallstones
CT scan – no abnormalities found
Known iron-deficiency anaemia due to severe menstrual bleeding
History of hiatus hernia
Echocardiogram (3 years ago) showed minor murmur
Pain is not cyclical or typical of period pain
No diagnosis yet established
New acute development:
Area of pain now extremely hot to the touch
Severe tenderness, worsening pain
Recent dizziness and two blackouts – possibly linked to anaemia or another cause
Red flag symptoms:
New localised heat over the painful area
Pain unrelieved by painkillers
Syncope (blacking out) episodes
Severe anaemia
Action requested:
Urgent reassessment with escalation to surgical/gynaecology review. Possible need for repeat imaging (e.g. HIDA scan, MRI, or laparoscopy) to rule out missed gallbladder pathology, endometriosis, or intra-abdominal inflammatory process.'