a Lump in the Lower Left Abdomen: Causes and When to Seek Help

A mass is palpated in the left lower abdomen?

Hello Dr.
Ke, recently while showering, I suddenly felt a horizontal elongated lump near my left lower abdomen close to the hip bone, approximately 3 to 5 centimeters in size.
It is not painful when pressed (though I occasionally feel something unusual, possibly due to frequently pressing it).
Sometimes it is more prominent, and other times less so.
I can feel it clearly whether before or after a bowel movement.
I do not have significant abdominal pain, and my bowel movements are relatively normal (about once a day).
There is no blood in my stool (I had a negative fecal occult blood test at the clinic in April).
My stools are formed but tend to have grooves (I have hemorrhoids).
I am 32 years old and have undergone laparoscopic surgery to remove my gallbladder.
Could this be a remnant from the surgery, or could there be other possible causes? I feel anxious and wonder if I need to see a doctor for an examination.
Which specialty should I consult? Thank you for taking the time to address my concerns; I greatly appreciate it.

james, 40~49 year old female. Ask Date: 2018/06/28

Dr. Ke Fangxu reply Surgery

The exact issue can only be determined through a personal examination by a physician.
Remote consultations cannot provide a definitive diagnosis.
I recommend that you consult the surgeon who performed your gallbladder surgery.
If they suspect any other problems, they will naturally arrange for further examinations.

Reply Date: 2018/06/28

More Info

Hello! Thank you for reaching out with your concerns regarding the lump you discovered in your lower left abdomen. Based on your description, there are several potential causes for this lump, and it's essential to consider various factors before determining the next steps.

Possible Causes of the Lump
1. Hernia: One of the most common causes of a lump in the abdominal area is a hernia. This occurs when an organ or tissue pushes through a weak spot in the abdominal muscles. Given your history of laparoscopic surgery to remove your gallbladder, it's possible that a hernia could have developed in that area.

2. Lymphadenopathy: Enlarged lymph nodes can sometimes present as lumps in the abdomen. This can occur due to infections, inflammatory conditions, or even malignancies.

3. Lipoma or Cyst: A lipoma is a benign tumor made of fat tissue, while a cyst is a sac filled with fluid or semi-solid material. Both can occur in the abdominal area and are usually not painful unless they become large or infected.

4. Post-Surgical Changes: Since you have a history of abdominal surgery, the lump could be related to scar tissue or adhesions that have formed after your gallbladder removal. These can sometimes create palpable masses in the abdomen.

5. Gastrointestinal Issues: Although you mentioned normal bowel movements and no significant abdominal pain, gastrointestinal issues such as diverticulitis or other inflammatory conditions could also present with lumps or masses.

When to Seek Help
Given that the lump is persistent and you have concerns about it, it is advisable to seek medical evaluation. While the lump is not painful and you are not experiencing significant gastrointestinal symptoms, any new or unusual mass should be assessed by a healthcare professional.

Recommended Next Steps
1. Consult a Specialist: You should consider seeing a gastroenterologist or a general surgeon. A gastroenterologist can evaluate gastrointestinal causes, while a general surgeon can assess for hernias or other surgical-related issues.

2. Diagnostic Imaging: Your doctor may recommend imaging studies such as an ultrasound or CT scan to get a clearer picture of the lump and its characteristics. This can help differentiate between a hernia, cyst, or other masses.

3. Physical Examination: A thorough physical examination is crucial. The doctor will assess the lump's size, consistency, mobility, and any associated symptoms.

4. Monitoring: If the lump is not causing any discomfort and your doctor believes it is benign, they may suggest monitoring it over time. However, any changes in size, shape, or associated symptoms should prompt a re-evaluation.

Conclusion
In summary, while the lump you have described could be due to various benign causes, it is essential to have it evaluated by a healthcare professional to rule out any serious conditions. Given your previous surgical history and the nature of the lump, a consultation with a gastroenterologist or general surgeon would be the best course of action. They can provide a comprehensive evaluation and recommend appropriate diagnostic tests to determine the underlying cause of your symptoms. Don't hesitate to seek help; your health and peace of mind are paramount.

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