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Lump under jaw, hard - Online Doctor Chats

Date : 21-Feb-2012
User rating for this question
Very Good Posted in: Dental Health
Answered by

General & Family Physician
Practicing since : 2004
Answered : 37 Questions
Doctor :   Hi
User :   hello
Doctor :   How can I help you?
User :   im concern with the hard, none moving lump under my jaw
User :   its only painful when touch
Doctor :   Since when have you noticed this lump?
Doctor :   And may I know the approximate size of the lump?
User :   like 3-4 months
User :   i cant tell really but its a little bit smaller than a marble
Doctor :   Have you seen a doctor?
User :   not yet
User :   like 2 weeks ago this area got swollen
Doctor :   Does it appear to be a single lump or a cluster of small nodular swelling?
User :   but when you touch it you would at once fell that theres a hard rounded thing inside
User :   only 1
Doctor :   Ok
User :   and it doesnt move like when you have cold
Doctor :   Is it in the centre or on the side of the jaw?
User :   no its like going towards the chin
User :   when i touch it not even my throat feels it already
Doctor :   Do you have redness over the surface of the lump?
User :   none
Doctor :   Do you have any difficulty in swallowing?
User :   a fews days already yes
User :   but not that bad
Doctor :   Ok
Doctor :   Do you have fever?
User :   but i cant feel it when chewing
User :   none
Doctor :   Do you have any past medical illness such as diabetes, dental problems?
User :   none
Doctor :   Ok.
Doctor :   Let me brief you.
User :   ok
Doctor :   Since you describe the lump to have grown in the last 2 weeks and there is tenderness, there
Doctor :   are possibilities that it is a sign of inflammation.
Doctor :   You would need evaluation and if need appropriate antibiotics to treat the condition.
Doctor :   Hence I would suggest you to consult your doctor to obtain the medication.
User :   inflammation because of what?
Doctor :   Probably because of an infection.
Doctor :   This conclusion is based on your symptoms and history alone.
Doctor :   So I suggest you to see your doctor for physical examination and if needed to start antibiotics.
Doctor :   In the mean time, hot bag application or icing with the analgesics should also help in controlling the problem.
Doctor :   You can take tylenol or advil twice a day to restrict the inflammation and pain.
User :   i already have done that and its not helping, but when it was swollen the ice helped
Doctor :   You can add the analgesic medication along with the icing.
User :   but when i dont touch it i dont feel pain
Doctor :   tenderness refers to pain on touch.
Doctor :   Its one of the signs of inflammation.
User :   i have a ureteral stent, if ever there is infection in the lower abdomen can it be possible to cause this?
Doctor :   Most common cause of inflammation in the subcutaneous region is infection.
User :   its not just tender its literally hard like marble hard
Doctor :   The source of infection cannot be predicted unless specific tests are done. but based on your history,
Doctor :   the chances that it may have been due to ureteral stunts are very low to almost impossible.
Doctor :   Have you followed what I have suggested?
User :   oh ok, doctor i had whole abdominal ultrasound last 7/5/2010 would you be so kind in interpreting it?
Doctor :   Please proceed.
User :   mild hepatomegaly, w/ fatty inflitration
User :   non-demonstrated gall bladder, consistent w/ a post
User :   post-cholecystectomy status of the patient.
User :   The considerations should include: sa focus of duodenal gas, phlebolith, food particle, calcification, or a calculuswithin the cystic duct.
Doctor :   Ok
User :   presence of a persistent "bright" echo about 7.6 mm. size at the distal gall bladder fossa
User :   close ultrasound monitoring sudgested
User :   no evidence of biliary dilatation
Doctor :   Ok
User :   mild hydronephrotic change the right kidney drom a calculus (nephrolithiasis) of about 2.4cm. sixe w/in the mid lower medullary region of the kidney
User :   Tiny non-obstructing nephrolith, as described, left kidney
User :   Presence of a distal end of a stent within the urinary bladder, suggestively coming from the ureteral region.
Doctor :   Ok
Doctor :   Let me guide you.
User :   Presence of a distal end of a stent within the urinary bladder, suggestively coming from the ureteral region.
Doctor :   Do you want me to explain the whole thing or be specific on certain points?
User :   what you think is best
User :   Presence of significant urinary bladder retention of urine. Consider cystitis. Please correlate Status post-hysterctomy, with prominent Nabothian Cysts within the residual cervix, as described. Prominent right ovary, with developing follicles Non-demonstrated left ovary Negative for intra-pelvic fluid
Doctor :   Your liver is showing fatty liver changes.
Doctor :   This can be due to multiple causes which includes obesity and alcoholism and excessive cholesterol intake.
User :   ok,
User :   what about the one that says something they saw in the location where my gall bladder was removed
Doctor :   Gall bladder is not visualised in the scan.
Doctor :   This can happen due to multiple causes.
User :   bright echo, measuring about 7.6 mm., is persistently noted at the porta hepatis region, close to the common duct outline.
User :   what may be the things that wound cause that?
Doctor :   The bright echo that is noticed is described in the previous line
Doctor :   which is as follows, the duodenal gas, a calcified vein Phlebolith, food particle and so on.
User :   yes
Doctor :   This is the bright echo that is referred there.
User :   is that bad?
Doctor :   No, thats not bad.
User :   are there complications from that?
Doctor :   No, you do not have complications due to that.
Doctor :   And about your kidneys, there is a stone in the kidney.
User :   if ever how can a food particle be in that area?
Doctor :   A stone which is causing obstructive changes on the right kidney.
Doctor :   The food particles refers to the food particle in the gut.
User :   oh
Doctor :   The duodenum is very close to the gallbladder.
Doctor :   So a food particle in the second part of the duodenum can appear as bright echo in the region of gall bladder.
User :   because in that area also from after the gall gladder procedure i feel like something is giving pressure
Doctor :   So if at all it is that, then as you clearly see that would not be a problem.
Doctor :   So you need not worry about the bright echo mentioned in the report.
User :   ok
User :   but what do you think is causing the pressure in my chest?
Doctor :   Pressure in the chest can occur due to many factors,
Doctor :   A cardiac problem, lung problem, gastritis and most often they could just be a somatic problem
Doctor :   Somatic problems are caused by stress, anxiety and other psychological factors.
Doctor :   If your symptoms are severe, you would need evaluation which can include a cardiac evaluation.
Doctor :   Hence a physical examination is necessary too.
User :   my latest ECG is normal
User :   the problem in my chest is the pressure and difficulty in breathing
Doctor :   ECG is the primary investigation to diagnose a heart problem but not the sole investigation.
User :   and everytime from a sitting position standing up the head feels so light
User :   oh
Doctor :   Since I cannot perform a physical examination online on this chat, its very difficult for me to give a specific cause for your symptom.
Doctor :   I can only provide you with the information.
User :   yes
User :   but information from here is very helpful gives us idea what to do 1st
Doctor :   Hence my opinion is that you need to see a doctor for physical examination.
User :   i will
Doctor :   A physical examination can make things more clear.
User :   doctor lastly
Doctor :   This includes for both the lump and the pressure.
User :   what does EBL 3600ml means?
Doctor :   Yes, proceed with your query?
Doctor :   Do you mean estimated blood loss?
User :   yes
User :   how many bags would that be?
Doctor :   Ok, it refers to the amount of blood loss that can happen during a procedure.
Doctor :   Normal individual has about 5 litres of blood.
Doctor :   One bag contains 180ml of blood.
User :   for packed blood and fresh whole blood is it desame 180ml?
Doctor :   Its 180ml of fresh blood.
Doctor :   *whole blood i mean.
User :   oh and how many in fresh blood?
Doctor :   I am sorry, can you reframe your last question?
User :   how many in a unit of fresh whole blood
Doctor :   If one has to transfuse 3600ml of blood, then you would need 20 units of fresh blood.
Doctor :   However in practise this much is not needed.
User :   is it only fresh blood that has to be transfused?
Doctor :   Body can withstand upto 60 to 75% of blood loss
Doctor :   Blood transfusion will be needed immediately if there is bloodloss of more than this.
Doctor :   The amount of units that has to be transfused is dependent on the clinical condition of the patient.
User :   what is the abb. for fresh blood and packed blood?
Doctor :   If his general condition is good, then he may not need 20 units.
User :   can 3600ml EBL cause hypovolemic shock?
Doctor :   If his previous condition is normal and he does not have any other conditions, then 3600 EBL should not cause hypovolemic shock.
Doctor :   Shock happens only when the blood loss is more than 80%
User :   correct me if i understood wrong
Doctor :   The normal amount of blood in individual as mentioned to you is 5 lit that is 5000ml.
User :   3600ml of blood lost cant cause hypovolemic shock?
Doctor :   yes,
User :   very lastly docotr cause i forgot to ask
User :   is it possible that from a epidural anesthesia in an emergency situation procede to a spinal?
Doctor :   Epidural anaesthesia is different from spinal anaesthesia.
Doctor :   Its easier to give a spinal anaesthesia then an epidural one.
Doctor :   So this decision is taken by the anaesthetist during the surgery.
Doctor :   Have you followed?
User :   yes but if a person already had epidural anesthesia and an emergency massive bleeding occured can it be possible to change it to spinal anesthesia?
Doctor :   Usually in an emergency situations it is changed to a general anaesthesia, to keep the breathing well.
Doctor :   And again this decision is decided during the procedure alone.
User :   what is the procedure for a gen. anesthesia?
User :   is it thru the catheter from the epidural? or another injection?
Doctor :   A general anaesthesia basically involves 2 parts.
Doctor :   1. Giving an injection through an iv line to make the person fall unconscious.
Doctor :   this is referred to as induction.
Doctor :   Followed by endotracheal tube placement.
Doctor :   This is done to mechanically ventilate.
User :   so general anesthesia is done thru the tube in the mouth?
Doctor :   And the patient is kept in the unconscious state by the help of gas such as nitrous oxide which is an anaesthetic.
Doctor :   Placing the tube through the mouth is part of general anaesthesia and not the whole.
Doctor :   But endotracheal tube placements are done only during general anaesthesia.
User :   so if the patient is already with an epidural anesthesia will it be more harder for then to change it to spinal anesthesia?
Doctor :   Its not a regular procedure in other forms of anaesthesia.
Doctor :   Its not an hard procedure.
Doctor :   Spinal anaesthesia is just injecting the anaesthetic agent into the spinal canal.
Doctor :   Have you followed?
User :   yes
Doctor :   Do you have any other query?
User :   but with massive hemorrhage already taking place in that moment will it be difficult to put spinal anesthesia?
Doctor :   Well if its during the surgery, then as it involves changing the position of the patient and holding him there,
User :   that is also what i was thinking
Doctor :   if it involves change of anaesthesia, then it will be changed to general anaesthesia.
Doctor :   Have you followed?
Doctor :   Do you have any other query?
User :   having a massive hemorrhage already, and they already opened the abdominal it will be hard for them to change the position of the patient
User :   doctor is there any chance you would know a docotr that could do a review of a case from other country?
Doctor :   You mean to review a surgery?
User :   to review a gynecologic report for a surgery\
Doctor :   If you are looking for an second opinion from a gynaecologist, you can get it done from our website.
User :   i am trying to find an expert on gynecologic problems to review my case
User :   like someone to tell if what the report said are facts or not
Doctor :   Ok
Doctor :   I shall send you the link for obtaining the gynaecological second opinion.
User :   wow taking you
Doctor :   The doctors are experts in gynaecology.
User :   would they be able to explain what went wrong on the procedure?
Doctor :
User :   will i just copy paste it here?
Doctor :   Yes, you can copy and paste this link to the address bar.
User :   ok doctor thank you very much for helping me
Doctor :   you will be directed to 3 gynaecologist.
Doctor :   You can choose one from them.
User :   ok thanks
Doctor :   You can get a reply through a mail or you can have a talk with them.
Doctor :   Do you have any other query?
User :   no more thank you
Doctor :   Thanks for consulting me. Bye for now. Please refer your friends to our service.
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