Left Lower Abdominal Mass: When to Seek Further Evaluation

Left lower abdominal mass?

Hello Dr.
Lee, about two years ago, I noticed a hard lump in my left lower abdomen, approximately 1 cm in size.
It doesn't appear abnormal externally and doesn't cause any specific symptoms; pressing on it doesn't hurt, so I didn't pay much attention to it.
However, recently I've been feeling a bit of discomfort in that area, as if there is something inside.
About four to five years ago, I was diagnosed with irritable bowel syndrome, but it has improved since then.
My bowel movements have been relatively normal, although I occasionally experience diarrhea from eating something bad, which usually resolves within a day or two.
I have not experienced constipation.
I had an ultrasound, and the doctor didn't find any abnormalities.
At that time, I was too nervous to ask for clarification, but the doctor mentioned it could be a lipoma and didn't elaborate further.
I would like to know if there is a possibility of it being a colorectal condition and whether I need further examination.

Jiang Jiang, 20~29 year old female. Ask Date: 2016/05/02

Dr. Li Zhonghuai reply Surgery

Hello! Based on your symptoms, it is possible that you have an abdominal wall hernia, which may not be apparent when you are not straining.
Sometimes, if the abdominal wall is too thick, it may not be palpable, and ultrasound may not provide clear results.
It would be better to consider a self-paid abdominal contrast-enhanced CT scan to address your concerns.
Take care! Changhua Hospital cares about you!

Reply Date: 2016/05/02

More Info

Hello! Thank you for reaching out with your concerns regarding the left lower abdominal mass you've noticed. Based on your description, it seems you have been monitoring a 1 cm hard mass in your left lower abdomen for over two years, which has recently started to feel a bit uncomfortable. You also mentioned a history of irritable bowel syndrome (IBS) and that you have had normal bowel movements, with occasional diarrhea after eating something that doesn't agree with you.

First and foremost, it's important to understand that any new or changing mass in the abdomen warrants careful evaluation, especially if it has been present for an extended period. While the ultrasound you underwent did not reveal any significant abnormalities, the fact that you are now experiencing a sensation of fullness or discomfort in that area suggests that further investigation may be warranted.

Possible Causes of the Mass
1. Lipoma: As your doctor suggested, a lipoma is a benign tumor made of fat tissue. These are usually soft, movable, and painless. If it has not changed in size or character, it may not require immediate intervention, but monitoring is essential.

2. Hernia: A hernia occurs when an organ or tissue protrudes through a weak spot in the abdominal muscles. If the mass feels like it can be pushed back in or if it changes with movement, it could be a hernia.

3. Lymphadenopathy: Enlarged lymph nodes can sometimes present as masses in the abdomen. This can occur due to infections or other underlying conditions.

4. Gastrointestinal Issues: Given your history of IBS, it is possible that the mass could be related to gastrointestinal issues, such as diverticulitis or other inflammatory conditions.
5. Other Tumors: While less common, other benign or malignant tumors could also present as abdominal masses.

When to Seek Further Evaluation
You should consider seeking further evaluation if you experience any of the following:
- Change in Size or Shape: If the mass increases in size or changes in consistency, this should be evaluated.

- New Symptoms: If you develop new symptoms such as pain, changes in bowel habits, unexplained weight loss, or fever, you should consult a healthcare provider.

- Persistent Discomfort: If the sensation of fullness or discomfort persists or worsens, it is advisable to seek further evaluation.

Recommended Next Steps
1. Consult a Gastroenterologist: Given your history of IBS and the current concerns about the mass, a gastroenterologist can provide a thorough evaluation. They may recommend further imaging studies, such as a CT scan, to get a better view of the mass and surrounding structures.

2. Consider a Biopsy: If imaging suggests that the mass may be concerning, a biopsy may be necessary to rule out malignancy.

3. Monitor Symptoms: Keep a detailed record of any changes in symptoms, including bowel habits, pain levels, and any other relevant information to share with your healthcare provider.

4. Lifestyle and Dietary Adjustments: Since you mentioned occasional gastrointestinal upset, consider keeping a food diary to identify any potential triggers. This can be helpful for your healthcare provider in managing your IBS symptoms.

In conclusion, while the mass you have described may be benign, it is essential to remain vigilant and proactive about your health. Regular follow-ups with your healthcare provider and timely evaluations can help ensure that any potential issues are addressed promptly. Please do not hesitate to seek medical advice if you have any concerns or if your symptoms change. Your health is paramount, and staying informed is key to managing your condition effectively.

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