Searching for Diagnosis

[Alanap]

Hello,

I have been struggling with a variety of symptoms for over a year and am badly in need of an answer. I have constant pain in my lower right abdomen, just to the left of my pelvic bone and under my right rib cage (on the left side). Sometimes the pain is on top of the right rib cage and I've recently noticed that it has radiated to my back. I also noticed that I have a 1-2 inch mass in my abdomen (left side) which my doctor believes to be muscle but which moves around quite a bit. I have lost about 10 pounds and don't feel hungry very often. I've noticed that my heart rate seems to be elevated and I have a low grade (99) fever pretty frequently), also I have shortness of breath on occasion. In addition, my glands around my neck seem to be pretty sensitive. I am a 29 year old female who used to be a moderate drinker but have pretty much altogether quit recently.

So far I have had 2 vaginal ultrasounds, 2 right abdominal ultrasounds, a CT scan, 2 blood work ups (including liver tests), some type of test that looks to whether there is inflammation in organs, a colonoscopy and an endoscopy. Everything came back fine except for I had three small benign polyps in my colon and a little irritation in the esophogus (also benign). My doctor recommended that I have another CT scan since mine was about a year ago.

I'm concerned that I have either a dangerous mass in my abdomen that is being misdiagnosed or liver disease/cancer or ovarian cancer. How fast can these things grow? In light of the fact that these tests were all within the past year should I be concerned about the mass? Are there other tests that you would recommend, liver biopsy, HIDA scan etc? My doctor seemed to shy away from gallbladder saying I would be naseaus all the time if something was wrong.

Any advice that you have would be great, I'm pretty much going nuts here.

Thanks,
Alana

[Alanap]

Thank you for your feedback. I have one follow up question, I had the CT scan a year ago and am having another tomorrow. Can a liver mass grow that quickly? It is to the right of my belly button and goes all the way up to the area under my ribs.

I'm super freaked out so any advice would be great.

[Kevin Pho, MD]

Cancer would have been seen with the colonoscopy, along with the ultrasounds and CT scans.  Specifically, ovarian cancer would have been excluded with the vaginal ultrasounds.

If the persistent pain continues in the right lower quadrant, you can consider Crohn's disease.  A push enteroscopy is a test that can evaluate the small bowel for this.  

I would also consider blood antibody tests to look for celiac disease, which can present with this presentation.

If there continues to be suspicion of a mass, an MRI can be considered, which is a more sensitive test than a CT scan.

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.

Kevin Pho, M.D.

KevinMD.com
Twitter.com/kevinmd