Prominent endometrial and endocervical fluid on CT

I have had intense abdominal pain for 10 days w/ nausea, vomiting, IBS symptoms, bloated & my GP sent me 2 days ago for a CT scan to R/O appendicitis.  I have Diverticulitis & I somewhat understand what diverticulitis is but would welcome any advice. The CT scan also showed "prominent endometrial and endocervical fluid" & my doc. referred me to GYN for consult. I called to schedule & the GYN is at a conference & my appt. is 10 days away.  What does too much fluid mean? Is it an indicator of cancer or whats the likelihood of cancer because I have heard GYN cancers are the silent killers?  Or, is it an indicator of another type of px? My red/white blood cell count was normal, hemoglobin, etc normal w/ a small amount of white cells in my urine. I have HBP & Type II diabetes that is controlled & I am about 45-55 lbs over weight but have gained 25 lbs in the last year w/ no diet changes. I am white, married and age 39.  I have not been to the OB/GYN for almost 2 years & never had abnormal test although I had a IUD for 10 ten years that was removed & mild Endometriosis at my last GYN exam. My period is suppose to start in 5 days...although heavy w/ cramping it lasts no more than 4 days. I've never had chn/pregnancy & do not have sex pxs or chronic hx of UTI's. My MGM had colon cancer. No other known family cancer hx. Also, I am worried because the GYN secretary/RN advised me to ask my HR person at work about FMLA. I've been working 1/2 days since I became sick 10 days ago.  I thought FMLA was for major issues so this suggestion has made me more concerned. Now my GP and the GYN offices are closed for the weekend & I cannot ask these qxs & I do not want to page anyone. I would greatly appreciate any and all information or advice you can offer.  

[Elaine Brown, MD]

Hi!
I have no idea why the receptionist would ask you such a strange question! I would speak sternly to my staff about saying something like that on a Friday!

Fluid in the uterus at your age is UNLIKELY to be cancer.  Given your history, I would wonder whether you have some type of cervical stenosis (blockage to the opening of the cervix) that is preventing all of your period from draining.  If my patient had your CT results, I would recommend an endometrial biopsy or D&C.  This would be both diagnostic and therapeutic.  It would rule out cancer of the endometrium and cervix (along with a PAP), and it would open up your cervix to prevent a re-accumulation of the fluid.  Maybe the receptionist was thinking that you would need a lot of time off for a D&C--but those are usually outpatient procedures, a biopsy is an office procedure, so you shouldn't need a lot of time.

One other possibility which I doubt because your WBC is normal--the infection from th diverticulitis could have spread to the uterus and the fluid could be pus. Treatment is the same, as long as you don't have high fever or unbearable pain.  Then it should be done sooner than 10 days.  But likelihood of cancer is very low.

I wish all of my patients were nice enough to write instead of paging!

Good luck!
Dr B

[challena]

Thanks for the quick and thorough answer!!  If I develop further pain or fever which would indicate infection over the weekend or before the GYN appt., I will go to the ER.  The fee for the online consult was worth the ease in my worry.  Hope you have a great and "quiet none pager beep" weekend!