[41F] With abdominal lump and pain

Patient Description

A 41-year-old female presents with a lump on the right side of the abdomen, just below the ribs, which has been present for approximately four months. The lump appears to have increased in size and causes a dull pain, rated 4 out of 10, especially when lying on the right side. The pain has been ongoing for about two months. The patient denies any recent weight changes, changes in appetite or digestion, nausea, vomiting, or jaundice. Fatigue and weakness have been noted, but there are no changes in bowel movements or urine color. The patient has a history of non-alcoholic fatty liver disease diagnosed four years ago and underwent gallbladder removal 13 years ago. She does not consume alcohol, has not been exposed to new medications or supplements, and has not traveled recently. Current medications include 70 mg of Methadone and 40 mg of Vyvanse daily. There are no known allergies or family history of liver disease or cancer. The patient has scheduled an appointment for further evaluation.

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Arora's Assessment

What might be happening

Based on the information you've provided, here are some possibilities:

  • Liver-Related Issues: Given your history of non-alcoholic fatty liver disease (NAFLD), the lump and pain could be related to liver enlargement or changes. NAFLD can sometimes lead to liver inflammation or scarring, which might cause discomfort.

    • Typical Testing: Blood tests to check liver function, imaging tests like an ultrasound or CT scan, and possibly a liver biopsy.

  • Hernia: A hernia occurs when an internal part of the body pushes through a weakness in the muscle or surrounding tissue wall. It can cause a noticeable lump and discomfort.

    • Typical Testing: Physical examination and imaging tests like an ultrasound or CT scan.

  • Lipoma or Cyst: These are benign growths that can occur under the skin and may cause a lump. They are usually painless but can cause discomfort if pressing on other structures.

    • Typical Testing: Physical examination and possibly an ultrasound.

What you can do

  • Consult Your Doctor: It's important to follow up with your healthcare provider for a thorough evaluation. They may recommend imaging tests or blood work to determine the cause of the lump and pain.
  • Symptom Tracking: Use MDandMe to journal your symptoms, track any changes, and share this information with your healthcare provider.
  • Pain Management: Over-the-counter pain relief, like acetaminophen, may help manage discomfort, but consult your doctor before taking any new medication.

What you should look out for

  • Seek Immediate Care If: You experience severe pain, fever, jaundice (yellowing of the skin or eyes), or any sudden changes in your symptoms.
  • Monitor Changes: Keep an eye on the size of the lump and any new symptoms that may develop.

Remember, this information is not a substitute for professional medical advice. Please consult a healthcare provider for a formal diagnosis and treatment plan.

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2 mo ago

People Also Ask

What could cause a lump on the right side of the abdomen?

A lump on the right side of the abdomen could be caused by several conditions, including liver enlargement, a hernia, or benign growths like lipomas or cysts. It's important to consult a healthcare provider for an accurate diagnosis.

How is non-alcoholic fatty liver disease related to abdominal lumps?

Non-alcoholic fatty liver disease (NAFLD) can lead to liver enlargement or changes, which might manifest as a lump in the abdomen. This condition can cause discomfort and should be monitored by a healthcare professional.

What are the common symptoms of a hernia?

Common symptoms of a hernia include a noticeable lump or bulge in the abdomen, discomfort or pain, especially when bending over or lifting, and sometimes a feeling of heaviness or pressure in the abdomen.

What tests are typically done to diagnose a lump in the abdomen?

To diagnose a lump in the abdomen, doctors typically perform a physical examination and may order imaging tests such as an ultrasound or CT scan. Blood tests might also be conducted to assess liver function if liver-related issues are suspected.

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