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Pain in abdomen. Had right ovary removed. Done ultrasound. Ct scan normal. Reason for the pain?

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White female age 39 200lbs. I had my uterus removed in 2009 and my right ovary removed in 2011. I have always had female issues. Pain in left lower side and mid ab section and my left side is larger a bit then my right side. This has been going on for about 3 months. She wants me to follow up with a gastro specialist which my appointment is this week. A ct scan two weeks ago LCT CT ABD/PEL w contrast. The doctor said their was a shadow around my left ovary. Today I had an ultra sound and v transvag also. My left ovary looks great and has eggs. They saw no problems with blood flow either. She could not get a view when she did the transvag and that really hurt a lot! But from the skin ultrasound she thought it looked good. On the ct scan my left ovary measured 2.8 x 2.6 x 3.6 cm. I saw on the monitor today that my ovary measured 3.6 x. 2.7 x ? ... I am really concerned as the shadow that was found on the left side around my ovary. I picked up the results and it says...."under the pelvic ct: Remaining left ovary within the left false pelvic measures 2.8 x 2.6 x 3.6 cm in size, possibly representing the palpable focus within the left lower quadrant. This appears solid and correlation with ultrasound, possibly MRI, is recommended in order to exclude an underlying solid mass within the remaining over. - and Evaluation of visualized large bowel demonstrates no obstruction or periintestinal inflammation. Mild sigmoid diverticulosis is present. Everything else on the CT Scan was normal.
My concern is why did the doctor tell me there was a shadow around my left ovary and nothing else. This is making me worry especially since my grandmother died of colon cancer. What could that shadow possibly be?
Posted Thu, 22 Nov 2012 in Women's Health
Answered by Dr. Timothy Raichle 9 hours later
Hello, I would be happy to help you with your question.

Here is what I am hearing:

1. You have had 3 months of LLQ discomfort
2. There was a pelvic exam done where a "palpable focus within the left lower quadrant" was felt.
3. An ultrasound of the LLQ was normal, with normal views of the left ovary
4. A CT scan showed a normal ovary, and it sounds like they are attributing the ovary to the "palpable focus" on exam. It does not sound like they saw anything else on CT scan, so I am not sure where the "shadow" comes into play. When you do ultrasound, the ovary will create a "sound shadow" as it blocks the soundwaves that are looking at it. But based on these imaging studies, it all sounds pretty normal.
5. The precancerous changes of the cervix are unrelated
6. You had uterine fibroids as the indication for the hysterectomy
7. The findings with the right ovary were likely unrelated to the current issue given the large amount of time that has passed.

So you are left with left sided pelvic pain and relatively normal imaging. Here is how I would approach something like this problem:

1. I would refer you to a GI doctor and let them go through the process of making sure that this was not a GI problem. They would probably need to go ahead and do a colonoscopy
2. If the GI workup was normal, then the decision making moving forward would probably be driven by your level of pain. If the pain was tolerable / minimal, then a followup ultrasound in 6-8 weeks would be a prudent way to proceed.
3. If the pain was not tolerable, then a discussion of a laparoscopy to see what is going on in the LLQ. You could have adhesions from prior surgery. It does not sound like cancer.

I hope this discussion helps. Please ask if you have more questions!
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