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What Causes Intermittent Right Lower Quadrant Pain Accompanied By A Mass?
Question: Hi, I'm a 50yo woman with DM1, I've had 2 spine surguries. The 2nd surgery they opened me ant. and post.. I'm giving you this info, as I believe it may relate to my condition.
What I'm experiencing is a RLQ pain accompanied by a palable mass, that never moves x 12 years, or since my last back surgury. The pain is not constant, but happens at least three times a day. And is always accompanied by the mass. I've had a colonostomy, Ct scan w/ & w/o cont., ultrasounds, inside and out. To no avail. Recently I was admitted to the Hospital w/ DKA, the first in my 27 year diabetic career, they're calling it pump failure. But my labs also show my white blood count as being 2 x what it should be. Any ideas that might help? PLEASE!!!!! Also, I should mention that the pain r/t the mass is extrere, when present. Relieved only by applying a tremendous ammont of pressure over the area.
What I'm experiencing is a RLQ pain accompanied by a palable mass, that never moves x 12 years, or since my last back surgury. The pain is not constant, but happens at least three times a day. And is always accompanied by the mass. I've had a colonostomy, Ct scan w/ & w/o cont., ultrasounds, inside and out. To no avail. Recently I was admitted to the Hospital w/ DKA, the first in my 27 year diabetic career, they're calling it pump failure. But my labs also show my white blood count as being 2 x what it should be. Any ideas that might help? PLEASE!!!!! Also, I should mention that the pain r/t the mass is extrere, when present. Relieved only by applying a tremendous ammont of pressure over the area.
Brief Answer:
most probably internal hernia
Detailed Answer:
Hi.
Read and re-read your history very carefully.
It may be a sequel or complication of the anterior approach surgery of the spine.
To recapitulate: Female/50 - DM1 - 2 spine surgeries - RLQ pain - palpable mass**- never moves - 12 years that is since the last surgery on back by anterior plus posterior approach - pain 3 times a day - and always accompanied by mass - pain r/t the mass is extreme and relieved only by applying a tremendous amount of pressure over the area.
My Thoughts:
Your history is classical of an internal hernia. This is the reason it is difficult to diagnose as the findings can be caught only if the internal hernia is obstructed at the time of examination (CT, USG or colonoscopy)
Hence I would advise you the following:
- Urgent X-ray in the standing position only when you are in pain. This simple X-ray can diagnose the internal herniation appearing as a mass and can give idea for further tests or management.
- Enteroclysis is a barium study under fluoroscopy control.
- Exploratory Laparoscopy or laparotomy: this will be diagnostic and can be therapeutic too.
Talk to / discuss with your Surgeon the above points and I am Sure about the diagnosis and results
I hope this answer helps you to get a proper diagnosis, and get a proper further treatment. Please feel free to ask for more or if you need further clarifications or if you feel there is a gap of communication.
most probably internal hernia
Detailed Answer:
Hi.
Read and re-read your history very carefully.
It may be a sequel or complication of the anterior approach surgery of the spine.
To recapitulate: Female/50 - DM1 - 2 spine surgeries - RLQ pain - palpable mass**- never moves - 12 years that is since the last surgery on back by anterior plus posterior approach - pain 3 times a day - and always accompanied by mass - pain r/t the mass is extreme and relieved only by applying a tremendous amount of pressure over the area.
My Thoughts:
Your history is classical of an internal hernia. This is the reason it is difficult to diagnose as the findings can be caught only if the internal hernia is obstructed at the time of examination (CT, USG or colonoscopy)
Hence I would advise you the following:
- Urgent X-ray in the standing position only when you are in pain. This simple X-ray can diagnose the internal herniation appearing as a mass and can give idea for further tests or management.
- Enteroclysis is a barium study under fluoroscopy control.
- Exploratory Laparoscopy or laparotomy: this will be diagnostic and can be therapeutic too.
Talk to / discuss with your Surgeon the above points and I am Sure about the diagnosis and results
I hope this answer helps you to get a proper diagnosis, and get a proper further treatment. Please feel free to ask for more or if you need further clarifications or if you feel there is a gap of communication.
Note: For further inquiries on surgery procedure and its risks or complications book an appointment now
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Answered by
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