Thread: Case Of 20-11-2007

A 17 Year Unmarried Girl Came Vt Complaints Of Vomiting Nd Fever Of 4 Days Duration. On Examination Abdominal Mass Upto Level Of Umbilicus Present On LEFT Side. In What Way U Will Proceed. Vts Ur Probable Diagnosis?

is she pregnant? Do urine hcg test.

no vitrag. im telling fever also. on examination mass was smooth surfaced, getting below not possible. k give me dd for mass abdomen in that age group nd gues again? one thing is pregnancy u r rit but fever vill not b there na.

Malaria
Diverticulitis
Hydronephrosis
Or any other inflammatory/malignant condition?

Check this thread for Differential Diagnosis of mass in LUQ abdomen.

I think you should give more info if answer is specific.. Post answer please..
Keep posting such interesting threads..

Vitrag, I think her mass is in the LLQ.

Here would be my differential diagnosis:

Hernia
Ectopic pregnancy --> get pregnancy test
Tubo-ovarian abscess
Ovarian cyst or carcinoma

• Yolk sac tumor (usually unilateral) --> get AFP and Alpha-1-antitrypsin
• Embryonal carcinoma (unilateral) --> get AFP and beta HCG

For imaging, I would start off with an ultrasound
Other labs, I would get ESR to rule out abscess

it can b huge mesentric cyst, encysted variant of tb ascites:as the mass is smooth surfaced r else it can b infected hydatid cyst of mesentry in addition to ovarian cyst. i wanna 2 do per rectal examination followed by ultra sound n ct abdomen.4r tb montou test if possible per vaginal exami

Originally Posted by bladder

Vitrag, I think her mass is in the LLQ.

opps.
i made mistake in hurry.

What's the corrent diagnoasis then? Ovarian cyst ??

Check Abdominal Mass [History & Examination] thread for details.

ya all of u guessd rit. bavana in mesenteric cyst getting below is possible nd in tb its a chronic condition vt repeated attaks of pain.

Here Is The Complete Case.
(1) History- 17 Yr Girl Unmaried Came Vt Complaints Of Fever,vomiting,abd Pain Of 4 Days Duration. She Complained Of Menorrhagia Also.
(2)gen Exam.- She Was Pale Nd Had Polio
(3)local Exam-firm Mass Upto The Level Of Umbilicus On Left Side. Freely Mobile Side To Side. Smooth Wall Nd Surface.
(4)ultrasound- Showed Multiple Echogenic Mass
First Suspected Dub And As She Was Pale Blood Transfusion Done. But Later Diagnosed As Ovarian Cyst.
On Laparotomy Omentum Is Covering The Cyst When Traced Down It Was Twisted Two Times., Severely Inflammed Nd Blood Got Collected In The Cyst. For God Sake Omentum Adhered To Cyst Otherwise Cyst Would Have Ruptured. Finally Mass Was Removed. Remember When The Cyst Is Twisted Dont Do Untwisting If U Do That Thrombi Already Formed Will Dislodge As Emboli. Also Dont Rupture The Mass Or Allow The Contents To Spill Into Peritoneal Cavity