Cystic Lesions in the Upper Abdomen: When to Consult a Gastroenterologist

Chest CT shows a cyst in the upper abdomen?

Hello, doctor.
I just had a chest CT, and I saw a statement in the report that says: "Two cystic mass-like lesions in the upper abdomen (Se2 Im122) up to 11 cm.
Suggest abdominal CT with contrast for further evaluation." However, the subsequent report states: "- No space-occupying lesion in the solid organs of the liver, spleen, pancreas.
- The intrahepatic and extrahepatic bile ducts and gallbladder are unremarkable." Does this indicate a problem in the abdomen, and should I be referred to a gastroenterologist?
A few months ago, I experienced occasional sharp pain in the lower right abdomen and often did not have the urge to have a bowel movement.
An abdominal ultrasound at the clinic showed a cyst in the liver, approximately 7 cm in size.
(If what was detected this time is also a liver cyst, it has grown from 7 cm to 11 cm in just over three months, which feels a bit alarming.) I was later referred to a hospital gastroenterology department, where they only performed a stool test and an abdominal X-ray, both of which were normal.
However, I still frequently feel bloated, especially after eating, and I feel full after consuming only a small amount of food.
After eating or drinking, my abdomen appears very distended.
I have previously undergone surgery to remove my entire uterus.
Thank you, doctor, for taking the time to respond amidst your busy schedule.

Xiao Yu, 40~49 year old female. Ask Date: 2023/09/13

Dr. Chen Shidian reply Gastroenterology and Hepatology

It seems that the default report text was forgotten to be updated.
After undergoing an ultrasound, regular follow-up (approximately once a year) is sufficient.

Reply Date: 2023/09/13

More Info

Understanding cystic lesions in the upper abdomen can be a source of concern, especially when there are changes in size or new findings on imaging studies. Based on the information provided, you have two cystic mass-like lesions in the upper abdomen measuring up to 11 cm, which were noted on a recent chest CT scan. The report also indicates that there are no space-occupying lesions in the solid organs of the liver, spleen, or pancreas, and that the bile ducts and gallbladder appear unremarkable.

Cystic lesions in the liver can be benign or malignant, and their management often depends on their characteristics, size, and associated symptoms. Common benign cystic lesions include simple liver cysts, which are typically asymptomatic and do not require treatment unless they cause symptoms or complications. However, the increase in size from 7 cm to 11 cm over a few months raises some concerns that warrant further evaluation.

Given your history of right lower abdominal pain and the sensation of fullness after eating, it is important to consult a gastroenterologist. They can perform a thorough evaluation, which may include additional imaging studies such as an abdominal CT with contrast, MRI, or even an ultrasound to better characterize the cystic lesions. The gastroenterologist may also consider other diagnostic tests to rule out any potential complications or associated conditions, such as infection or malignancy.

The symptoms you describe, such as abdominal bloating and early satiety (feeling full after eating only a small amount), can be related to several gastrointestinal issues, including functional gastrointestinal disorders, gastritis, or even complications related to the cystic lesions. Since you have undergone a hysterectomy, it is also essential to consider any changes in your abdominal anatomy that may contribute to your symptoms.

In summary, it is advisable to consult a gastroenterologist for a comprehensive evaluation of the cystic lesions and your gastrointestinal symptoms. They will be able to provide a more accurate diagnosis and recommend appropriate management based on the findings. Early intervention is crucial, especially if there are any changes in the size or characteristics of the cystic lesions, or if your symptoms worsen. Remember, timely consultation with a specialist can help alleviate concerns and ensure that any potential issues are addressed promptly.

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