Abdominal distension with pain

Chief Complaint A 42 y/o female presents with an abdominal swelling of 6 months duration and abdominal pain of 3 months. History No such compliant in past. No other past medical or surgical history. She has 2 kids, born with uncomplicated normal delivery. No history of irregular menstruation. Examination Abdominal was swelled & the liver and spleen were not palpable. Bowel sounds normal. Vaginal examination shows cystocele grade 1. Investigations HB 11.5 g/dl. All other blood investigations and chest x ray wnl. Sonography shows a huge abdominal cystic mass that compressing the organs. Left hydronephrosis was also noted. Uterus was normal and seen separate from the mass. Treatment What should we do next?

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Ovarian cyst is the first possibility. Laparotomy. HP investigation...

Adv ct abdomen and ct guided biopsy Sos go for laproscopic intervention Unless investigations are complete no opinions

Thanx dr Kute Ankush
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Based on the history and clinical profile, next line of action should be CECT abdomen and pelvis... D/D: Left Ovarian cyst Right ovarian cyst Mesenteric cyst Retroperitoneal cyst Also better to rule out tumor markers namely, CA125, CEA Plan: surgery based on the reports

? Ovarian cyst, ? Mesenteric cyst, ? Broad ligament cyst Adv CT scan of abdomen The cyst will need surgical removal

Maximum chance of being Ovarian cyst Prepare for ovarian cystectomy and its histopathology report

Thanks Dr. Kute Ankush , Dr. Shivraj Agrawal
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NEED'S.. CLINICOPATHOLOGICAL EVALUATION WITH .. CTCE STUDY.. EXPERTS OPINION..

Tnx Dr Vipin Bihari Jain sir
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Cystic ovarian mass is more likely. CT scan abdomen required.treatment depend on final diagnosis.

Need diagnostic laparotomy And need look for markers of abdominal tumors Complete evaluation

Diverticulosis punarnava arisht with viranga arisht 2 tsf tds

CBC LFT Serum CA 125 CECT abdomen and pelvis. She will need a staging laprotomy. Needs opinion from Surgical oncologist or gyne oncologist

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