Concerns Regarding Ultrasound Findings
Age: 35, Weight: Approximately 230 pounds, Height: 5’3" **Medical History:** Diagnosed with Hashimoto’s thyroiditis, mast cell disorder, hypermobility spectrum disorder, ADHD, OCD, anxiety, dysautonomia, migraines, irritable bowel syndrome (IBS), obstructive sleep apnea (OSA), and potential primary ovarian insufficiency (awaiting blood test for confirmation). Noteworthy is a recent diagnosis of pre-diabetes, as evidenced by an A1C of 6.7 with fluctuations observed over the last year in addition to thyroid levels. **Surgical Background:** Underwent an appendectomy, hysterectomy with salpingectomy, removal of the right ovary, lumbar fusion at L5-S1, repair of umbilical hernia, and treatment for left shoulder SLAP tear. **Current Medications:** Currently prescribed tirosint, astepro, Allegra, Pepcid, gabapentin, methocarbamol, EpiPen, Nurtec, Tylenol, Excedrin for migraines, ondansetron, ibuprofen, triamcinolone, clonazepam, estradiol, and calcium with Vitamin D. **Health Issues:** Persistent pelvic pain originated after the removal of the right ovary, which was necrotic due to torsion. After a consultation with my OBGYN, a pelvic ultrasound was recommended alongside additional blood tests. I am also experiencing sporadic pain in the abdomen on the left side beneath the sternum. The gastroenterologist suggested it might be muscular discomfort and declined further tests. Subsequently, my primary care physician ordered an abdominal ultrasound. **Results from Pelvic Ultrasound:** **Summary:** The examination revealed multiple simple cystic lesions in the left adnexa with the largest measuring 5.2 cm. Possible conditions include multiple small ovarian cysts and left-sided hydrosalpinx, with the presence of left ovarian cysts noted in a previous diagnostic laparoscopy conducted in 2025, which appears to be the more likely diagnosis. Measurement details: Left ovary size - Sagittal: 8.0 cm, AP: 4.8 cm, Transverse: 6.9 cm. **Detailed Report:** **Exam:** Limited pelvic ultrasound conducted on 02/11/2026, signifying concern for left ovarian cyst (diagnosis code N83.202). Previous comparisons include a pelvic ultrasound from 03/08/2022 and a lumbar spine CT from 05/07/2025. The procedure was performed endovaginally with proper consent. **Findings:** - **Uterus/Cervix:** Status post-hysterectomy. - **Ovaries:** Status post-right oophorectomy. Multiple cystic areas identified in the left adnexa. The largest cyst measured 5.2 x 4.6 x 5.4 cm and another one at the upper section of the left ovary measured 4 x 2.5 x 2.8 cm. Adequate blood flow was confirmed for the left ovary, which measured 8.0 x 4.8 x 6.9 cm. No abnormal fluid was found in the pelvic area. **Results from Abdominal Ultrasound:** **Summary:** Detection of borderline hepatomegaly with fatty liver changes, as well as borderline enlargement of the spleen. Key measurements include: - Liver: 16.8 cm - Common bile duct: 0.5 cm - Gallbladder wall: 0.20 cm (no stones or sludge noted) - Kidneys: Right kidney at 10.7 cm, Left kidney at 11.6 cm - Spleen: 12.9 cm - No signs of fluid accumulation. **Detailed Report:** **Exam:** Complete abdominal ultrasound performed on 02/11/2026 to address generalized abdominal discomfort. **Findings:** - **Liver:** Slightly enlarged with increased echogenicity; no focal lesions detected. - **Gallbladder:** Normal with no internal issues. - **Spleen and Kidneys:** Sizes within acceptable ranges with normal textures. No masses or stones observed in either kidney. **My Inquiry:** In the previous CT scan from September 2025, there were no signs indicating enlargement or swelling, just a mild suggestion of fatty liver, which might explain why the gastroenterologist overlooked my concerns. The ultrasound results depict significant changes over the past five months. I’ve been healthy since a sinus infection and bronchitis treated in December. Should I be alarmed? What inquiries should I pose, and whom should I follow up with? Is it best to approach my PCP, the gastroenterologist, or another specialist? Regarding the pelvic ultrasound mentioning left hydrosalpinx, I am puzzled as my fallopian tubes were surgically removed. What could be the reason for the considerable size of my left ovary? Should the dimensions of the cysts raise any alarms? I’ve reached out to the physician who ordered these tests, but my appointment isn’t until June due to scheduling challenges. Is there cause for worry, or any additional questions I should plan to ask? Any insights or guidance would be helpful.
Answers (1)
2/12/2026, 12:22:50 AM
OpenHealth AI
Thank you for sharing detailed information about your health concerns and ultrasound findings. It's understandable to feel anxious about these results, but let's break down the main points to clarify potential next steps.
Key Points:
- Ultrasound Findings: The pelvic ultrasound indicated multiple cystic lesions in the left adnexa, with one measuring 5.2 cm, and a diagnosis of borderline hepatomegaly with fatty liver on the abdominal ultrasound.
- Health History: Your medical history, including conditions like Hashimoto’s thyroiditis and pre-diabetes, adds complexity to your situation but also provides context for your symptoms.
- Next Steps: It's essential to follow up with the healthcare providers regarding these findings, especially considering the cyst sizes and liver changes.
Explanation:
- Ovarian Cysts: Multiple simple cysts in the ovary are common and often benign, especially when they are functional (related to your menstrual cycle). However, the size of the largest cyst (5.2 cm) and your previous history merit monitoring.
- Fatty Liver and Hepatomegaly: The liver findings can be related to dietary habits, weight, and metabolic conditions. While fatty liver often requires lifestyle adjustments, its presence along with enlarged spleen should be discussed further.
- Hydrosalpinx Note: If your fallopian tubes were removed, it's important to clarify this finding with your doctor. It’s possible that what was noted may represent cystic changes rather than true hydrosalpinx.
Actionable Next Steps:
-
Prepare Your Questions: Make a list of specific questions for your upcoming appointment in June. Consider asking:
- What are the implications of the cyst sizes, and what should I monitor?
- How can I effectively manage or reverse my fatty liver condition?
- Could the pelvic ultrasound findings (hydrosalpinx) be a misinterpretation, given my surgical history?
- Should I be concerned about the borderline hepatomegaly and the diet or lifestyle adjustments needed?
-
Follow Up With Your Primary Care Provider (PCP): Since your PCP ordered the ultrasounds, they may be the best initial contact to discuss results, as they can coordinate care with specialists if needed.
-
Lifestyle Management: Start considering or implementing lifestyle changes that support liver health, such as:
- Eating a balanced diet rich in fruits, vegetables, whole grains, and lean protein.
- Reducing sugars, saturated fats, and processed foods.
- Increasing physical activity if possible, aiming for at least 150 minutes of moderate exercise a week.
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Monitor Symptoms: Keep a symptom diary to track any changes in your pelvic pain or abdominal discomfort to discuss during your upcoming appointment.
Conclusion:
While the findings raise valid questions, many ovarian cysts and liver conditions can be managed appropriately with medical supervision and lifestyle changes. Stay proactive about your health, and don't hesitate to reach out to your healthcare team for updates or urgent concerns before your scheduled appointment. Your health is important, and addressing your worries with the right questions will help provide clarity and direction.
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