Right Lower Abdomen Mass: Pain with Urgency and Specialist Referrals - Oncology

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It sounds like you are experiencing a complex and concerning situation with your right lower abdomen mass, accompanied by pain and urgency. Given the extensive evaluations you've already undergone, including blood tests, urinalysis, X-rays, CT scans, and consultations with various specialists, it is understandable that you feel frustrated and uncertain about the next steps.

From your description, it appears that the initial concern for appendicitis has been ruled out, which is a positive development. However, the presence of a mass or shadow in the abdominal wall, along with your symptoms, suggests that further investigation is warranted. The fact that you have a history of hernia surgery raises the possibility of complications related to that surgery, such as scar tissue (adhesions) or other changes in the abdominal wall.

Here are some considerations and recommendations based on your situation:
1. Consult a General Surgeon Again: Since you have already seen a general surgeon, it may be beneficial to return to them, especially if they have experience with abdominal wall issues. They can assess whether the mass is related to your previous surgery or if there are other surgical options to explore. Sometimes, a second opinion from another general surgeon can provide new insights.

2. Consider Imaging Studies: If the ultrasound did not provide clear information about the mass, you might want to discuss the possibility of further imaging studies, such as an MRI or a repeat CT scan with a focus on the abdominal wall. These imaging modalities can sometimes provide more detailed information about soft tissue structures and help identify any inflammatory processes or masses that may not be visible on other scans.

3. Referral to a Gastroenterologist: Since your symptoms include urgency and pain, a gastroenterologist may be able to provide additional insights, especially if there are concerns about gastrointestinal function or motility. They can also evaluate for conditions such as inflammatory bowel disease or other gastrointestinal disorders that might not have been fully assessed during your previous evaluations.

4. Pain Management: While you seek further evaluation, managing your pain is crucial. Discuss with your healthcare provider about appropriate pain management strategies, which may include medications or other therapies that can help alleviate your discomfort.

5. Monitor Symptoms: Keep a detailed record of your symptoms, including when they occur, their intensity, and any associated factors (like diet or activity). This information can be invaluable for your healthcare providers in diagnosing the issue.

6. Consider a Multidisciplinary Approach: Given the complexity of your symptoms and the various specialists involved, a multidisciplinary approach may be beneficial. This could involve collaboration between general surgery, gastroenterology, and possibly even pain management specialists.

7. Follow-Up: Ensure that you have a clear follow-up plan with whichever specialist you decide to see next. It’s important to have continuity of care and to ensure that all your concerns are addressed.

In conclusion, while it can be frustrating to navigate through multiple specialists without a clear diagnosis, persistence is key. Continue to advocate for your health, seek further evaluations, and consider a multidisciplinary approach to address your symptoms comprehensively. Your health and well-being are paramount, and with the right support and investigation, you can find the answers you need.