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Have Nausea, Vomiting, Abdominal Pain, Back Pain, Fever. Found Small Cyst On Ovary. Ovarian Cancer?

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Posted on Thu, 2 May 2013
Question: Help! I have been having the following symptoms for a Month, nasuea and vomiting after eating, lower abdominal pain, sever lower back pain, stabbing pain in upper abdomen, fullness after small amounts of food, bloating, fatigue, low grade fever, weight loss, and my period is 2 weeks late.

I have had a colonoscopy, CT scan, multiple pregnancy test, abdominal and pelvic ultra sounds, and a hydascan today. Everything looks good except for a small cyst on my ovary, hemangianoma on my liver, and during the ultra sound only the left side of my bladder would fill up. This resulted in unclear images of the left side of my pelvis and no images of the ovary with the cyst. I was in so much pain from the gallon of water in my bladder my back was spasaming and I vomited. The doctors can't find anything, they have looked at my gallbladder since all signs pointed to that but it's fine. I am at my wits end and I need help. I feel crazy because no one can find anything but something is wrong. Can you give me any ideas as to what this might be? Could it be ovarian cancer? I am 31 with one child who I had via c section. I feel horrible all the time and have pretty much stopped eating due to the pain and nausea. Please help me!!!
doctor
Answered by Dr. Prasad Akole (6 hours later)
Dear friend, welcome and thanks for entrusting your query here at Healthcaremagic!
I am Dr. Prasad Akole (Critical Care Expert- http://bit.ly/Dr-Prasad-Akole) and am glad to address to your query here.


I can understand your agony. You have undergone most of the common investigations needed for such symptoms. It is a complex case.

Abdomen is considered a “Pandora’s box” full of surprises for doctors.

Your pain, fever, weight loss, back pain, lower abdominal pain all point to a pelvic inflammatory pathology. Bladder is central single organ and cannot have left side. Do you mean partial visualization? It may occur in external compression by a mass.

Ovarian cyst if rupturing or torsion can cause such symptoms. Ovarian cancer with distant metastasis is one of the differentials. endometriosis, PID (pelvic inflammatory disease), cancer, infections are possible.
CT scan would have picked up any bladder, pelvic genital tract, GI tract abnormality, tumours, masses, compressions etc.

However, fullness, bloating, vomiting after small quantity of food, pain point to a possible separate/ related stomach outlet problem. Liver, gall bladder are unlikely sources. Pancreatitis must be ruled out (but CT scan, USG would have picked it up)

Such upper symptoms may occur in gastric outlet obstruction and is due to tumour, contracting big ulcer, wall thickening from various causes.

An upper gastrointestinal endoscopy is needed for its evaluation.

It would greatly help if you could upload all your reports here using the uploading service available on this site just below the text box. You can email the reports / scans to
YYYY@YYYY
with subject- (Attn: Dr. Prasad Akole)

This will tell me exactly what they have found out till now and then advise you accordingly.

Have you been passing stools and gas normally?
Is urine output normal? Do you have any difficulty urinating?
Is the abdomen distended? Can you see visible bowel contractions in the upper abdomen?
Has a complete blood work up been done?

In such difficult cases, one needs patience and systemic work-up.
You may take OTC acetaminophen for pain (upto 1 gm 4 times a day), chewable ondansetron 4 mg 3 times a day for vomiting.

You may need a team of surgeon, gastroenterologist, gynaecologist, physician to evaluate further if needed. You deserve a hospital admission and thorough evaluation rapidly.

Let me first have a look at all your reports.

I hope to have answered your query satisfactorily. I would be glad to answer any further queries.
Take care and please keep me informed of your progress at http://bit.ly/Dr-Prasad-Akole
Good Luck!

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Prasad Akole (13 hours later)
Hello Dr Akole,
Thank you for taking the time to answer my question and to answer it with detail. I know that I have a complex case here and I appriciate you taking the time to go over all of the possible reasons for my symptoms.
To answer some of your questions, I am having normal urination with no pain. I have been having abnormal bowels but my stomach is not distended nor can you see the bowels moving through my abdomen. They ran my blood when I went to the ER two weeks ago and everything came back normal. I went to the ER because the lower back pain and abdominal pain had become unbearable and I was running a 101.9 fever. My concern was that I had a kidney stone but the CT scan showed that I did not. I don't believe that I have IPD because I am not having any discharge. My next step was to go see my OBGYN if my gastroenterologist does not find anything from the Hydascan. My concern is that my symptoms are being brushed off as IBD or something less serious. I have been in pain for a month now and I have no appetite. If I do eat I am sick so really there is no point. I am having low radiating abdomen/ pelvic pain all the time especially on my left side. Would you recommend seeing my OBGYN?
doctor
Answered by Dr. Prasad Akole (2 hours later)
Thanks for the update.

I again see that UTI is less likely with normal urination and clear blood lab.
Surprisingly the CT does not reveal anything. Was it a contrast CT (CECT)?

I would still insist on reading all your reports here to know the exact wordings.
Something is definitely pointing to the left flank / pelvic pathology. IBS can not be ruled out , but colonoscopy is normal you say.

I would suggest an UGI (upper gastro intestinal) endoscopy to rule out stomach/ duodenal obstruction, a gynaec and SOS a urology opinion.

Why do you not insist on getting admitted to a hospital and get thorough evaluation under one roof? I would do that. You have high chances of being malnourished and develop complications.

Hope to have helped you a bit.
Would await some reports.


Note: For further queries related to kidney problems Click here.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
Answered by
Dr.
Dr. Prasad Akole

Internal Medicine Specialist

Practicing since :1996

Answered : 961 Questions

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Have Nausea, Vomiting, Abdominal Pain, Back Pain, Fever. Found Small Cyst On Ovary. Ovarian Cancer?

Dear friend, welcome and thanks for entrusting your query here at Healthcaremagic!
I am Dr. Prasad Akole (Critical Care Expert- http://bit.ly/Dr-Prasad-Akole) and am glad to address to your query here.


I can understand your agony. You have undergone most of the common investigations needed for such symptoms. It is a complex case.

Abdomen is considered a “Pandora’s box” full of surprises for doctors.

Your pain, fever, weight loss, back pain, lower abdominal pain all point to a pelvic inflammatory pathology. Bladder is central single organ and cannot have left side. Do you mean partial visualization? It may occur in external compression by a mass.

Ovarian cyst if rupturing or torsion can cause such symptoms. Ovarian cancer with distant metastasis is one of the differentials. endometriosis, PID (pelvic inflammatory disease), cancer, infections are possible.
CT scan would have picked up any bladder, pelvic genital tract, GI tract abnormality, tumours, masses, compressions etc.

However, fullness, bloating, vomiting after small quantity of food, pain point to a possible separate/ related stomach outlet problem. Liver, gall bladder are unlikely sources. Pancreatitis must be ruled out (but CT scan, USG would have picked it up)

Such upper symptoms may occur in gastric outlet obstruction and is due to tumour, contracting big ulcer, wall thickening from various causes.

An upper gastrointestinal endoscopy is needed for its evaluation.

It would greatly help if you could upload all your reports here using the uploading service available on this site just below the text box. You can email the reports / scans to
YYYY@YYYY
with subject- (Attn: Dr. Prasad Akole)

This will tell me exactly what they have found out till now and then advise you accordingly.

Have you been passing stools and gas normally?
Is urine output normal? Do you have any difficulty urinating?
Is the abdomen distended? Can you see visible bowel contractions in the upper abdomen?
Has a complete blood work up been done?

In such difficult cases, one needs patience and systemic work-up.
You may take OTC acetaminophen for pain (upto 1 gm 4 times a day), chewable ondansetron 4 mg 3 times a day for vomiting.

You may need a team of surgeon, gastroenterologist, gynaecologist, physician to evaluate further if needed. You deserve a hospital admission and thorough evaluation rapidly.

Let me first have a look at all your reports.

I hope to have answered your query satisfactorily. I would be glad to answer any further queries.
Take care and please keep me informed of your progress at http://bit.ly/Dr-Prasad-Akole
Good Luck!