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What causes severe pain in the lower left abdomen?

DOCTOR OF THE MONTH - Feb 2018
Feb 2018
User rating for this question
Very Good
Answered by

General Surgeon
Practicing since : 1984
Answered : 16135 Questions
Question
Please help!!! I have had lower left quadrant pain for a couple years and been to over a dozen doctors with no solutions. When I sit it feels as though I am sitting on my left testicle and the pain refers up to my lower left abdomen area. I have been told I could have intermittent torsion and set up for surgery but 3 other doctors said I do not have the condition. I also have been told I could have "nut cracker syndrome" but after MRI's that was ruled out. I am at my capacity for this...It seems like a chord or vain on my left side that runs from my Testicle to my lower abdomen my be torn, ruptured or somehow injured causing pain.
Thu, 14 Jun 2018 in Abdominal Pain
 
 
Answered by Dr. T Chandrakant 3 hours later
Brief Answer:
Please give details and post actual reports.

Detailed Answer:
Hi.
Thanks for your query.
Noted the history and understood the concerns.
As per the history you have provided my thoughts are as follows:
Such a pain that runs from left testicle to left lower abdomen - may be torn, ruptured or somehow injured causing pain - can most probably be of neurogenic that is involvement of the nerve supplying this area getting trapped or stretched or so or akin spontaneous discharge of signals causing the pain.
Left Inguinal hernia.
Muscle spasm, fibromyositis in this area.
Testicular problems.

Please give details of the area the MRIs were done and post the reports of all the investigations done till now.
Please also give additional information for me to assist you better:
Any past history related to any direct or indirect injury to the lower left abdomen and/or scrotum?
Any swelling in the inguinal area or scrotum?
Any urinary or bowel symptoms?
What is the frequency of pain?
Any other investigations?

Please give feedback and post reports attached to this query.
Above answer was peer-reviewed by
 
Follow-up: What causes severe pain in the lower left abdomen? 3 days later
I did have pain in my lower left abdomen about 12 years ago for a couple months but it went away. I thought it was from a medication I was taking(Tramadol). It was right along my belt line but never went down thru the groin area like I have now. There is no swelling but when I lay down there feels like a small sack just above the left testicle(not sure if this is normal). The only time I do not have severe pain is when I wake. I will send a the reports from the MRI when I find them.
 
 
Answered by Dr. T Chandrakant 27 minutes later
Brief Answer:
Stalked cyst is possible

Detailed Answer:
Tramadol does not cause such pain in the routine way and this happened about 12 years back.
Feeling of a sac like thing when you lay down can be due to epididymal cyst or any other cyst and this is a stalked one can rotate and cause the pain as you have mentioned.
Ultrasonography with color doppler or MRI should show what it is.
Awaiting for the reports.
Above answer was peer-reviewed by
 
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