Unexplained Abdominal Swelling in Older Women

Left abdominal swelling issue not resolved?

My mother is 67 years old.
About a month and a half ago, she developed a red, swollen, hard mass the size of an egg in her lower left abdomen, which was painful to the touch and had localized warmth.
Two different surgical departments performed ultrasounds but found no results, and they recommended further observation.
Within a month, the swelling spread near her genital area without clear borders, and a third surgical department was also unable to identify the issue.
She is currently hospitalized for suspected arthritis and is undergoing further examinations.
Initially, the surgical team stated that her case was unusual and would require additional testing.
I inquired with the physician whether the initial abdominal ultrasound included an examination of the uterus and ovaries, and as is typical, it did not.
Now, the redness and swelling have increased, extending to her lower right abdomen.
I once watched a Japanese family medicine program where a woman had a similar condition, but she had purulent drainage, which my mother does not have.
I am determined to find answers, but I feel anxious and powerless.
Thank you in advance for your help!

Wu Yu, 30~39 year old female. Ask Date: 2007/06/11

Dr. Zhou Dali reply Obstetrics and Gynecology

Your description cannot lead to a diagnosis.
The Japanese program you mentioned is essentially a variety show that tends to sensationalize obscure cases, so please don't frighten yourself unnecessarily.
It is advisable to consult your attending physician directly if you have any concerns.

Reply Date: 2007/06/11

More Info

When dealing with unexplained abdominal swelling in older women, especially in a case like your mother's, it is crucial to approach the situation with a comprehensive understanding of potential underlying causes and the appropriate steps to take. Your mother, at 67 years old, has presented with a significant abdominal issue characterized by a hard, painful swelling in the left lower abdomen that has since spread. Given her age and the complexity of her symptoms, a thorough evaluation is essential.

First, it is important to consider the differential diagnoses for abdominal swelling in older women. The swelling could be due to a variety of factors, including but not limited to:
1. Infections: Conditions such as abscesses or infections in the abdominal cavity can lead to localized swelling and pain. If there is an infection, it may not always present with fever or systemic symptoms, especially in older adults.

2. Tumors or Masses: Both benign and malignant tumors can present as abdominal masses. In older women, gynecological issues such as ovarian cysts, fibroids, or even ovarian cancer should be considered, particularly if imaging studies have not provided clear answers.

3. Hernias: An inguinal or femoral hernia could present as a swelling in the lower abdomen or groin area, especially if it is painful and changes with position or activity.

4. Inflammatory Conditions: Conditions such as diverticulitis or appendicitis can cause localized swelling and pain. In older adults, the presentation may be atypical, making diagnosis challenging.

5. Lymphatic Issues: Lymphedema or lymphadenopathy can cause swelling in the abdominal area, particularly if there is an underlying malignancy or infection.

Given that your mother has already undergone ultrasound examinations without conclusive results, it may be beneficial to consider further imaging studies. A CT scan of the abdomen and pelvis could provide a more detailed view of the structures involved and help identify any abnormalities that may not have been visible on ultrasound.

Additionally, since your mother is experiencing a spread of the swelling and has a history of suspected arthritis, it may be worthwhile to consult with a rheumatologist. Some autoimmune conditions can cause abdominal swelling and pain, and a multidisciplinary approach may be necessary to arrive at a diagnosis.

In the meantime, it is essential to monitor her symptoms closely. If she experiences any new symptoms such as fever, increased pain, changes in bowel habits, or any signs of systemic infection, she should seek immediate medical attention.

Lastly, it is understandable to feel anxious and helpless in this situation. The process of finding a diagnosis can be frustrating, especially when symptoms are vague or do not fit neatly into a specific category. It is important to advocate for your mother's health by ensuring that all potential avenues for diagnosis are explored and that she receives the appropriate follow-up care.

In summary, unexplained abdominal swelling in older women can stem from a variety of causes, and a thorough evaluation is essential. Consider further imaging studies, consult with specialists as needed, and keep a close watch on any changes in her condition. Your proactive approach in seeking answers for your mother is commendable, and with persistence, a diagnosis can often be reached.

Similar Q&A

Understanding Abdominal Distension: Possible Causes Beyond Pregnancy

Hello Doctor, I would like to inquire about a female family member who is 42 years old. She started experiencing abdominal swelling two years ago, initially thinking she was pregnant, as it appeared that way. However, this has persisted for two years. She is reluctant to seek med...

Dr. Cao Guotao reply Obstetrics and Gynecology
Hello, you may still need to go to the hospital for an examination to determine the cause of the abdominal swelling. Wishing you good health.

Understanding Unexplained Leg Swelling in Elderly Patients: Causes and Solutions

Hello Dr. Hsiao, I would like to inquire about my grandmother (who is 82 years old). Last month, her lower legs, insteps, and toes suddenly became swollen (like edema, leaving an indentation when pressed). She is currently unable to walk or stand up, and even slight movements cau...

Dr. Xiao Yongxun reply Family Medicine
Dear Miss Xiao Bei: 1. There are many causes of lower extremity edema, with common ones including heart failure, nephrotic syndrome, liver failure or cirrhosis, deep vein thrombosis of the lower limbs, cellulitis, lymphedema, hypothyroidism, and side effects of medications, amo...

Understanding Abdominal Pain in Middle-Aged Women: When to Seek Help

Hello, my mother is 47 years old and experiences abdominal pain (approximately above the navel) upon waking up. What could be the cause? If she needs to go to the hospital, which department should she visit? Thank you.

Dr. Cai Jueren reply Family Medicine
Hello: Generally speaking, abdominal discomfort is either pain or unease. We typically use the term "soreness" to describe muscle or joint pain. If the abdominal soreness is isolated and not accompanied by other symptoms such as nausea, vomiting, indigestion, diarrhea, ...

Finding the Right Specialist for Complex Abdominal Symptoms

My mother is currently 73 years old and has diabetes, heart disease, and hypertension, which she manages with regular doctor visits and medication. This year, she has experienced discomfort in two areas of her body. The first issue is that she often feels tightness on both sides ...

Dr. Xiao Jingqin reply Internal Medicine
The patient's primary pain is located in the lower abdomen, and it worsens with walking. They also experience loss of appetite and a tendency to feel bloated, which may not necessarily indicate a gastric issue. If we narrow down the problem to the lower abdomen, potentially ...