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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Suggest Treatment For Severe Abdominal Pain And Bloating

Hello! On December 26th of 2016 I arrived at the ER just shy of 8am due to extreme abdominal pain that started around 1pm on Christmas Day. Once I was taken back to my room at the ER and administered morphine and dilauded through my IV (which hardly even touched the pain) the ER physician thought my pain could be due to my appendix. I was then taken back for a CT scan where the results of that testing showed I had a large black mass in my lower pelvic region and they were unable to find my left ovary. The physician then ordered a transvaginal ultrasound as well as an abdominal ultrasound which again showed the same results; large black mass and the inability to detect my left ovary. Due to these tests and my extreme and intolerable pain (so much so I had reached the limit of pain medicine they could administer without going over the lethal limit) the on-call OB/GYN physician was alerted to see me and review the unfortunately, inconclusive results. Once he arrived I explained in detail what and where I was experiencing all of this distress. He ordered a vaginal examination in which he was not comfortable using the speculum due to my pain and the severe swelling/bloating as time had gone on (at this point, my 120 lb, size 2 body looked like I was 3-4 months pregnant). He proceeded to tell me that with history of ovarian cancer in my family, and hemorrhagic cysts in my right ovary from over a year before, he wanted to perform an exploratory laporotomy to see if there was a torsion or something else that was causing this. If there was a need to remove the left ovary, he would have to do so during surgery. I signed the papers agreeing that I knew what needed to take place and the risks involved with said surgery. After I was admitted for a 3-day evaluation and watch in the hospital, I had come to from the anesthesia around 11pm the night of my surgery (which took place at 6pm) and was made aware that they had to remove my left ovary because I had a 12.7 cm dermoid tumor that had taken it over completely and caused bleeding internally, putting pressure on my lungs, stomach, intestines, and so forth. My tubes were left in tact along with my right ovary and uterus as they appeared to be functioning appropriately and would have no further issues. Since January 6th, I have been bleeding consistently everyday, soaking through a minimum of 2 overnight sized pads. My normal menstrual cycle starts on the 8th of every month so I was not shocked when I first started bleeding, however I have no gone through 2 menstrual cycles and I am still bleeding heavily and constantly and will soon be arriving for my 3rd menstrual cycle in just 2 short weeks. My follow up with the surgeon was a short visit that did not consist of a thorough examination or ultrasound and no follow up from there requested from my doctor. I m 23 years old, anemic, have emotional and psychological issues prior to this and the constant bleeding and unwarranted pain I m still having alongside the fatigue and hot flashes associated, are really keeping me from getting any better. Why am I still bleeding this heavy and for this long after my surgery? I can t imagine this would be considered normal. But I need answers and/or advice to put everything at ease. Thank you in advance for anything you can tell me regarding my situation. Kelsi Stevenson
Mon, 26 Nov 2018
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General & Family Physician 's  Response
Hi,

As per my clinical experience, the issue of heavy menses after the laparotomy sounds to be co-related with either hormone imbalance, drug-related side effect, endometriosis or other associated uterine condition adjacent to ovarian dermoid.

A thorough clinical work up with basic lab tests and hormone evaluation are mandatory to proceed ahead.

Hope I have answered your query. Let me know if I can assist you further.

Regards,
Dr. Purva Patel,
General & Family Physician
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Suggest Treatment For Severe Abdominal Pain And Bloating

Hi, As per my clinical experience, the issue of heavy menses after the laparotomy sounds to be co-related with either hormone imbalance, drug-related side effect, endometriosis or other associated uterine condition adjacent to ovarian dermoid. A thorough clinical work up with basic lab tests and hormone evaluation are mandatory to proceed ahead. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Purva Patel, General & Family Physician