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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Severe Bouts Of Abdominal Pain. Have Bowel Obstruction. Is It Concerning Possible Neoplastic Process?

i HAVE HAD SEVERAL BOUTS OF ABDOMINAL PAIN RECENTLY WAS HOSPITALIZED FOR LEFT ABDOMINAL PAIN THAT WAS SEVERE. THEY DID AN SONOGRAM THINKING IT WAS MY OVARIES, AND IT WAS NORMAL, RAN BLOOD WORK, CBC WAS ELEVATED IT WAS 11.8, RBC 4.35 HMG 11.8 HCT 35.7 NEUTROPHILS 7.0 LYMPHOCYTES 3.4 AND EOSINOPHIL 0.3. STARTED ME ON ANTIBIOTICS AND RAN A CT WITH CONTRAST AND SEEN DISTAL SMALL BOWEL IS DECOMPRESSED. THERE IS SMALL BOWEL WALL THICKENING INVOLVING A LOOP OF SMALL BOWEL WITHIN THE LEFT HEMIABDOMEN, LIKELY THE ETIOLOGY FOR THE LOW GRADE PARTIAL OBSTRUCTION. NO FREE INTRAPERTONEAL GAS OR FOCAL FLUID COLLECTION WITHIN THE ABDOMEN. NO RETOPERITONEAL LYMPHADENAPATHY, MINIMAL ABDOMINAL AORTIC ATHEROSCLEROSIS , WITH OUT EVIDENCE OF ANEURYSMAL DILATATION. FINDINGS: COMPATIBLE WITH A LOW GRADE PARTIAL SMALL BOWEL OBSTRUCTION SECONDARY TO SMALL BOWEL WALL THICKENING WITHIN THE LEFT HEMIABDOMEN. THE SMALL BOWEL WALL THICKENING MAY REPRESENT AN ENTERITIS. A NEOPLASTIC PROCESS CANNOT BE EXCLUDED, ALTHOUGH THOUGHT TO BE UNLIKELY GIVEN THE MODERATE LENGTH SEGMENT OF SMALL BOWEL WHICH IS THICKENED. PAIN WAS A LITTLE BETTER AFTER ANTIBIOTICS. NOT REAL SURE BUT WBC WENT DOWN TO 6.9, THE RBC 3.91 AND HMG 10.6 AND HCT 31.7, THE RED COUNT SEEMED TO GO DOWN MORE WHEN WHITE COUNT WENT DOWN. NOT SURE WHAT THIS MEANS, IS THIS TO BE CONCERNING WITH POSSIBLE A NEOPLASTIC PROCESS. I HAVE A GASTRO WHOM IS TRYING TO ORDER UP A PUSH ENTEROSCOPY AND SINCE IT IS NOT USUALLY DONE AT THE HOSPITALS HERE HAS TO GET THE HOSPITAL BOARD PERMISSION. NEVER HEARD OF SUCH A THING. IS THIS SOMETHING THAT I REALLY NEED. THANKS. I AM 41 YR OLD FEMALE, WITH DIABETES TYPE 2 AND GASTROPARESIS,
Mon, 17 Sep 2012
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Radiologist 's  Response
Hi,welcome to HCm
The small bowel thickening causing partial obstruction in your age (41) is least like to be neoplastic. so dont worry too much.
On lab reports and CT scan report it is more likely to be infective as you are also a diabetic.
I will suggest wait for some time , bec]cause no need to go for enteroscopy . continue with your treatment and then wait and watch. If u fell better then go for follow up CT scan after 2 years.
If there is again small small obstruction then go for enterosopy and biopsy.
thankig you
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General & Family Physician Dr. Das Arindam's  Response
Hi, welcome to HCM i am Dr Das
Yes,you really need that. Because visequalization of the affected region is verymuch needed. As regular endoscopy would reveal anything it is better to go for enteroscopy .
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Severe Bouts Of Abdominal Pain. Have Bowel Obstruction. Is It Concerning Possible Neoplastic Process?

Hi,welcome to HCm The small bowel thickening causing partial obstruction in your age (41) is least like to be neoplastic. so dont worry too much. On lab reports and CT scan report it is more likely to be infective as you are also a diabetic. I will suggest wait for some time , bec]cause no need to go for enteroscopy . continue with your treatment and then wait and watch. If u fell better then go for follow up CT scan after 2 years. If there is again small small obstruction then go for enterosopy and biopsy. thankig you