Managing Lesion of Adnexa
Q: I am a 34 year old female. I went to the ER with severe abdominal pain localized above my naval. Blood work showed increased white blood cell count. CT scan, pelvic and abdominal ultrasounds showed a rt adnexal lesion and free fluid in the pelvis. I will have a follow up with my gynecologist and family physician. I also have shortness of breath and difficulty with bowel movements for 2-3 weeks. What can cause this, and treatment?
Right adenexa means, all the structure present on the right side of the uterus. This would include the right ovary, the right fallopian tube and the ligaments and muscles supporting the uterus.
A rt. adenexal lesion may be a mass/ lesion arising from the ovary, the tube or the uterus itself !
It cannot be said with certainty what it is.
You need thorough follow ups. Your doctor will first investigate to find out from what tissue this lesion is arising. A tissue sample (biopsy) may be required.
If it is from the ovary, it may be an ovarian cyst. These are common in your age group. This may be benign or cancerous.
Since you have mentioned some free fluid in your pelvis, the possibility of malignancy needs to be ruled out. Although, you are young for any cancers.
It may be some lesion arising from the tube.
The tube on the right side may be swollen due to some infection. Such a condition is called hydrosalpinx (water in tube).
Many PIDs (pelvic inflammatory diseases) present in this way. The inflamed tube may have given you the pain. Did you have any fever along with it?
Such condition are treated with antibiotics. Sometimes, surgical drainage of the tube is required.
Endometriosis in the Tube
Here the uterine tissue grows outside the uterus to give a mass like lesion. Since this tissue secretes during monthly cycles, fluid is collected. The patient usually complains of irregularity of menses and pain during bleeding.
Tumor in the Tube
This is extremely rare.
The lesion could be a tubo-ovarian abscess. This is collection of pus in the rt. adenexa. The condition is secondary to some pelvic infection.
This is a growth from the muscular wall of the uterus. The condition is painful. Menstrual disturbances often accompany.
Any mass in the right adenexal region can press over the nearby bowels to disturb bowel movements.
Your need to get diagnosed first. Depending upon what the adenexal mass is, treatment would be given.
You may read about a similar problem here.