Nodule on liver

I had my ovaries removed in Oct and have had abdominal pain on my right and left sides of my stomach.  After a CT scan I was told I have a punctate nodule of 2 mm in the lateral part of the right lobe of my liver and that my rectum and proximal sigmoid has very apparent wall thickening.  Can you please help better explain what all of this means and what should I do next.  I have been in pain for going on 6 months because they thought all my pain was coming from my ovaries that had cysts and mass on them.

Thank you
Anne

[Enoch Choi, MD]

WOW, WOW, WOW, WOW, WOW, WOW!!!  you've lost a ton of weight, great job!  

Oftentimes, a CT scan can characterize a lesion on the liver and the radiographic appearance is important to consider when figuring out whether or not to do anything further.  A gastroenterologist is a great specialist to consider if a particular liver lesion needs to be further analyzed.  A liver biopsy is relatively routine, but has potential side effects that are worth avoiding (bleeding), especially if the appearance on CT is benign.

Rectosigmoid swelling of the bowel wall can be from imaging error, inflammation, infection, tumors (benign or malignant) and should be followed up.

[swtest1]

Hi Anne:

I wanted to ask if a liver biopsy has been considered? Also, are you diabetic? Have you ever been diagnosed with fatty liver disease?

I ask these questions and will share with you what happened to me. I am a type II diabetic and was diagnosed in 1999 with fatty liver. In July 2008 I had pain just like you and I went through several tests and they all came back normal. My gastroenterologist then said we need to do a liver biopsy and I was devastated when the news came back that I had non-alcoholic cirrhosis of the liver caused by fatty liver disease. I had 2 nodules on my liver, but for now, my liver is functioning normally.

I was told by my doctor that it could not be reversed, but the process of it becoming worse could be slowed down by - 1) weight loss, 2) eating foods high in protein and fiber, 3) little to no fat in my diet, 4) getting my blood glucose levels lower and 5) exercise.

I cannot say whether this is the issue for you and I am not a doctor, but I believe that you should have a liver biopsy to see what is going on with your liver and to get a good diagnosis so you know what you're dealing with. Also, I wanted to mention that there is a doctor called a "hepatologist" who specializes in liver diseases (also they specialize in transplants)  and I see one every 6 months for a follow-up and monitoring of my liver problem. I recommend that you at least see a hepatologist to discuss the cause(s) of your liver issue. Also, I recommend that you continue to see your gastroenterologist (if you don't have one, consider seeing this type of doctor) for your other issues as he/she should suggest doing a colonoscopy/sigmoidoscopy to see what is going on with your lower colon. See http://www.righthealth.com/topic/Sigmoid_colon/overview/adam20?fdid=Adamv2_003885 for a description of what the sigmoidoscopy is and how it is performed.

Also, when I was in pain with my liver, my gastroenterologist gave me a pain medicine named Tramodol. I found it to be helpful, it didn't make me sleepy and I wasn't afraid to use it like I am with most pain meds.

I hope this helps.

Good luck to you and keep your head held high,
Kim

[girls12]

First off thank you so much for helping.  I have not had a liver biopsy and still awaiting on the lab results.  As far as I know I am not diebitic.  I am going to get a referral from my primary doctor tomorrow to go see a speciallist and know.
Over the last year I have lost 100 pounds and have tried to exercise but with several surgerys it has been difficult to exercise.

Again I thank you for taking time to help answer my questions.  I hope you are doing well.

Anne

[swtest1]

I was glad to share what I could with you Anne. I know how painful all this is - physically and emotionally. As one doctor told me on my search for what was wrong "You have to be your own health advocate". For those who look at the doctors as miracle workers, yes they are life savers but rightly in their own field. What I found from personal experience is that if I went to a cardiologist, he/she might not consider issues outside the area of heart diseases. If I can be of anymore help, just contact me.

Have a blessed Holiday,
Kim