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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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What Are Swollen Lymph Nodes, Loose Stools And A Lump In Lower Abdomen Suggestive Of?

This question is regarding my 23 year old son. He currently attends school away from home in a small Canadian community. In mid october he complained of right lower abdominal pain and swelling. Felt like there was a lump there. This persisted over ~1 week and worsening. I told him to go to ER. He went and was admitted overnight. They thought possibly appendicitis. Gave IV fluids, ketoralac and if not improved in the morning would send out. In the morning pain was improved but not gone. Elevated WBC. A week later he noted his eyes were yellow. Went back to ER, 5 times normal bill. Remainder of LFTs normal. Sent home. When bloodwork was repeated a few weeks later he had elevated AST, ALT (3 times normal), bili(4 times normal). Ordered abd US. Apparently normal except for polyp in gall bladder. Bunch more bloodwork ordered for hepatitis screens, STDs (not sure what else). Immunizations UTD including Hep A and B. Right lower abdominal pain and lump has persisted the whole time. Lymph nodes now swollen everywhere, loose stools, no blood in stool (that he has seen), weight loss (~5 lbs in a week). Fatigued. He was a previously well young man. Did suffer a concussion in July and August 2016, with post concussive symptoms. Not overweight (6 feet 2 inches…was 190 lbs now 176). Very active previously. Eats healthy. No ETOH since concussion. He has travelled to Africa ~2 years ago, was ill will severe diarrhea following a trip to Mexico ~22 months ago. Thoughts??
Fri, 8 Feb 2019
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General & Family Physician 's  Response
Hi,

Sorry to hear about his problem. There are many possibilities and I would suggest now this should be properly investigated by doing gland biopsy.

The possibility may be a chronic infection like TB, Hiv, mono, etc, other possibilities are blood disorders like anaemia or uncommonly blood cancers.

The best way forward is that we should now take a biopsy of the lymph gland. This would need a minor operation but would very likely tell us the diagnosis in few weeks.

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

Take care

Regards,
Dr Mahboob Ur Rahman , General & Family Physician
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What Are Swollen Lymph Nodes, Loose Stools And A Lump In Lower Abdomen Suggestive Of?

Hi, Sorry to hear about his problem. There are many possibilities and I would suggest now this should be properly investigated by doing gland biopsy. The possibility may be a chronic infection like TB, Hiv, mono, etc, other possibilities are blood disorders like anaemia or uncommonly blood cancers. The best way forward is that we should now take a biopsy of the lymph gland. This would need a minor operation but would very likely tell us the diagnosis in few weeks. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Mahboob Ur Rahman , General & Family Physician