Understanding CT Scan Results
I would greatly appreciate assistance in interpreting the findings from my chest and abdominal CT scans. Any advice on next steps would be immensely helpful. Thank you! I’m a 24-year-old female collegiate athlete who generally enjoys great health and hadn’t seen a doctor in two years. Recently, however, I’ve experienced a range of concerning symptoms: persistent fatigue, fever, intermittent shortness of breath, ongoing nausea, and frequent headaches. Additionally, I’m dealing with sporadic abdominal discomfort and some swelling in my legs that feels unusual. My blood pressure readings typically fall between 130/85 and 140/100. I've also noticed some pain and discomfort in the upper left side of my abdomen. Over the last three months, I’ve lost between 15 to 20 pounds, which is alarming given my athletic background. Findings from my chest scan: - The left lobe of my thyroid appears to be absent or significantly underdeveloped, while the rest of the thyroid is normal. - No enlarged lymph nodes were observed in the axillary, hilar, or mediastinal areas. - The thoracic aorta appears normal in size with no signs of dissection. - The main pulmonary artery is notably enlarged, measuring approximately 2.8 cm across, which exceeds the size of the aorta. There were no detected abnormalities in the pulmonary arterial tree that would indicate a blood clot. - No fluid accumulation was present in the pericardial or pleural spaces. Summary: 1. There are no acute issues in the chest area. 2. The main pulmonary artery is enlarged compared to the aorta, which may be a non-specific finding that can sometimes indicate pulmonary arterial hypertension. Findings from my abdominal scan: - The liver, spleen, pancreas, right adrenal gland, and kidneys appear to be normal. - A small nodule on the left adrenal gland was detected, measuring roughly 1.6 x 1.0 cm. - The urinary bladder looks normal overall. - There are multiple uterine fibroids/masses located mainly on the anterior and right sections of the uterus, with the largest measuring close to 3.9 cm in size. - An incidental finding suggests a small cyst or dominant follicle in the left ovary. - The surrounding adnexal structures are otherwise normal. Report highlights: 1. No acute findings present in the abdomen or pelvic region. 2. Presence of multiple uterine masses/fibroids reaching almost 4 cm. 3. A small nodule on the left adrenal gland noted; it is recommended to have a follow-up adrenal CT or MRI in 12 months to monitor stability.
Answers (1)
4/3/2025, 7:01:20 PM
OpenHealth AI
Thank you for sharing your CT scan findings and symptoms. Given your concerning symptoms like fatigue, weight loss, and discomfort, let’s break down the critical aspects of your scans and outline actionable next steps to address your health concerns.
Summary of Key Findings:
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Chest Scan:
- Enlarged main pulmonary artery, which may suggest a potential issue like pulmonary arterial hypertension but is not currently indicating any acute problems.
- Absence of enlarged lymph nodes and no fluid accumulation in major cavities, which is reassuring.
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Abdominal Scan:
- Identified a small adrenal nodule and multiple uterine fibroids, with the largest fibroid measuring nearly 4 cm. No acute abnormalities were found in major organs.
Explanation of Findings:
- Enlarged Main Pulmonary Artery: This could indicate increased pressure in the pulmonary arteries, which may need further evaluation. It’s a non-specific finding, meaning it often requires more follow-up to understand the cause.
- Adrenal Nodule: While small, follow-up imaging is recommended to ensure it doesn't grow or change, which can be organized in a year.
- Uterine Fibroids: Common and generally benign, these can cause symptoms but are often monitored rather than treated unless they are causing significant issues.
Next Steps:
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Track Symptoms: Given your ongoing symptoms including fatigue, weight loss, and abdominal discomfort, it’s essential to keep a daily log of your symptoms, noting when they occur and their intensity. This will help highlight patterns and aid discussions with a healthcare provider.
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Hydration and Nutrition: Focus on maintaining good hydration and nutrition. Since you’ve lost weight, consider meeting with a nutritionist or dietitian to ensure you’re getting adequate calories and nutrients, which can help with fatigue and overall recovery.
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Follow-Up on Adrenal Nodule: Plan for a follow-up adrenal CT or MRI in 12 months as recommended. Keep a note of your symptoms in case they change, which could prompt earlier imaging.
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Discuss with a Healthcare Provider: Schedule an appointment with a healthcare provider to discuss your symptoms in detail and review your CT scan findings. Given your age, activity level, and concerns, this is important for your peace of mind and to determine a tailored plan for any necessary evaluations or treatments.
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Manage Blood Pressure: Your blood pressure readings are slightly elevated. Consider lifestyle modifications such as reducing salt intake, engaging in regular physical activity, and practicing stress management techniques like mindfulness or yoga.
Reassurance:
It’s great that you are tracking these symptoms and obtaining imaging studies. While some of your findings require follow-up, there are no acute issues currently, which is a positive aspect. You’ve taken important steps by seeking clarity about your health, and addressing these issues with appropriate providers will help ensure your well-being.
Feel free to reach out if you have more questions or if there's anything else you need help with as you take these next steps.
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7 Months Old) - **Weight:** 9 kg (good growth rate in spite of condition) - **Jaundice:** Continues to be present (yellow skin) - **Stools:** Remain pale/clay-colored - **Development:** Achieving appropriate milestones - **Energy:** Appears to have a good energy level - **Feeding:** Normal appetite --- ## QUESTIONS FOR r/AskDocs We have been informed this is **Type 2 Abernethy malformation** (portal vein present). **Three treatment avenues have been proposed:** ### Option 1: **Endovascular Coil Embolization** (minimally invasive approach) - A catheter is inserted via the leg vein to access the shunt and deploy coils/plugs to close the abnormal vessels - Pros: No surgical incision, minimal discomfort, short hospital stay (2-4 days), no scars, enhanced safety - Duration: 1-2 hours - Recovery: 2-4 weeks for jaundice to show improvement ### Option 2: **Open Surgical Intervention** - An incision in the abdomen to ligate abnormal vessels and redirect blood to the liver - Pros: Direct visualization, effective results - Cons: Surgical scar, longer recovery time (7-14 days in hospital) - Duration: 2-4 hours ### Option 3: **Liver Transplantation** - We have been advised this is not necessary as the portal vein is functional and liver health is improving. --- ## SPECIFIC QUESTIONS TO CONSIDER: 1. **With a functional portal vein (6.1 mm) and improving liver function (ALT normalized), is it advisable to pursue endovascular closure as the preferred treatment?** 2. **Despite ALT levels improving, the bilirubin remains consistently high (242). Should this be a cause for concern? Is there a prospect for it to normalize post shunt closure?** 3. **Are the hemangiomas/nodules (11.6×20.7 mm) linked to the shunt? Will they likely resolve following shunt repair?** 4. **How urgent is the proposed intervention? Is immediate action required, or is there flexibility to wait a few months?** 5. **What complications should we be vigilant for during the waiting period?** 6. **Regarding endovascular closure - what is the average success rate for infants aged 7 months? Are there concerns regarding the shunt size (9.9 mm)?** 7. **The measurement of the portal vein has shown improvement from 6.1 mm to 3.9 mm; should this be perceived as a positive sign or a reason for concern?** 8. **Are there special directives (diet modifications, medications) we should consider while awaiting the procedure?** 9. **Post-procedure, how long should we expect it might take for:** - Normalization of bilirubin levels? - Return of stool color to normal? - Resolution of jaundice? - Regression of hemangiomas? 10. **Can you recommend any specialized centers for pediatric Abernethy malformation treatments? We are located in Uzbekistan but are prepared to travel (to Turkey, Russia, South Korea, etc.)** --- ## ADDITIONAL INFORMATION - No family history of hepatic diseases - Pregnancy and delivery were normal - No additional congenital defects identified - Immunizations up to date - No history of bleeding disorders - No signs indicative of encephalopathy - Child is alert and engaged --- **I can supply actual MSCT images and comprehensive lab reports if they would be of assistance.** We sincerely appreciate any insights you can provide. We are striving to make the most informed decision regarding our daughter’s care and highly value expert medical opinions. **TL;DR:** 7-month-old diagnosed with Abernethy Type 2 malformation (9.9 mm portocaval shunt, patent portal vein). Liver functionality is improving (normalized ALT) while bilirubin remains elevated (242). Evaluating options between endovascular coil embolization and open surgery. Seeking expert advice on optimal treatment strategy and timing.