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CT of the abdomen and pelvis with and without contrast
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CT of the abdomen and pelvis with and without contrast

I am a 50 year old woman. I am worried because I am feeling abdominal pain, many months ago, specially towards the left side of my abdomen, my abdomen is bloaded and I have never had this huge stomach(I work out very much).It is very easy to see a prominence towards my left side. Almost where my left ovary is. i thought it was an inguinal hernia...but it is not and hernia.  I still have my menstruation cycle.

I had a CT Scan(pelvic and abdominal), and the results of my CT Scan are:

INDICATION: The patient with pelvic pain and history of ovarian cysts.

"The liver shows no ductal dilatation. There are multiple fluid density lesions within the liver, the largest of which is located at the right hepatic dome and measures 2.8 cm. The lesions measuring less than a centimeter in size are to small to be accurately characterized.

The uterus is noted to be bulky and heterogenous.  There is prominence of the left adnexa, too small to characterize. There is no free fluid or significant pelvic sidewall lymphadenopathy. There is no significant inguinal lymphadenopathy.

The spleen,pancreas,adrenal glands and kidneys are unremarkable. There is no free fluid or significant upper retroperitoneal lymphadenopathy.
The bowel demonstrates no evidence of focal obstruction.
IMPRESSIONS
1.- Multiple fluid density masses along the right aspect of the liver, likely representing cysts. this to be confirmed with utrasonography as the lesions measuring less than a centimeter in size are too samll to accurately characterize.
2.- No free fluid or significant lymphadenopathy.
3.- Heterogeneous and bulky uterus with mild prominence of the left adenexa. this may represent leiomyomatous change. Correlation with pelvic utrasonography is recommended.

As you can see i would like to have an opinion from you doctors.  I feel confused and do not know if this is serious, or I do not have to worry so much.  What would be my next step?

Thank you very much and may God bless you all
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Surgeon has kindly shared his thoughts in his comments below and I agree with his assessment.

I would suggest the followup studies including the adominal (abdominal) and pelvic ultrasound as was mentioned in the imporession.

Most liver cysts are benign.  Uncommonly they grow large enought to cause problems and very rarely are they dangerous to the patient.  The ultrasound would be the best test to further define what kind of cyst it is.  

The left adnexal enlargement isn't well defined by the CT scan.  I would suggest the pelvic ultrasound to further see what it is (i.e. cyst vs mass).

Followup with your personal physician is essential.

This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.

Thanks,
Kevin, M.D.
1 Comment
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Of course the best source of info is from your own doctors, who ordered and will be interpreting the test. Basically, however, it shows not much: the things in the liver sound like cysts, which are fluid collections and are quite common and not significant. It probably ought to be confirmed, as suggested, by ultrasound just to be sure. The uterus sounds enlarged, but with the characteristics of a fibroid; that's also common and not a dangerous problem. It might be up to your gynecologist to decide if it could have anything to do with your symptoms, and what needs to be done to evaluate it further. A CT scan is not the best way to rule out all things possible, especially regarding the colon. So, it may be that if a gynecologist doesn't think your uterus is the source of your symptoms, further exam of your colon would be in order.
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