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Dr. David
Dr. David, Board Certified MD
Category: Medical
Satisfied Customers: 45238
Experience:  Board Certified Physician
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3 months ago. Had 2 episodes of v severe left abdominal pain

Customer Question

3 months ago. Had 2 episodes of v severe left abdominal pain clammy pale etc. Went to A&E had pelvic ultrasound unable to see left side due to bowel,discharged as probable ovarian accident. Since then have had Left sided lower abdominal swelling one the left side my groin crease is a lot longer and I have a tummy apron on one side this was not there before. I get pain in the groin and abdomen. When I sit down It feels like there is something there and I physically have to lift that side up an over to feel more comfortable. Leaning forwards at the waist like I am touching my toes creates pain. There is no pattern to the pain in that I can be laying down and have pain. Together with this at times I have had intense pain in the back of my left knee. The back of knee has swelling which caused the skin to split a little. The veins are prominent and by the end of the day feels that they are literally popping out.
Submitted: 2 years ago.
Category: Medical
Expert:  Dr. David replied 2 years ago.

Dr. David :

This is Dr. David

Dr. David :

this lower left abdominal pelvic pain can come from bad ovarian cysts

Dr. David :

or could be coming from diverticulosis if small bits of hard stool or food like corn or nuts or seeds are getting trapped in your colon wall lining.

Dr. David :

you need a pelvic ultrasound to check for ovarian cysts

Dr. David :

and if you are constipated or have small hard bits of stool or eat corn or nuts or seeds prior to these pain episodes, you have to avoid them in your diet

Dr. David :

and use stool softeners and laxatives to soften your stool.

Customer:

I had a pelvic ultrasound which showed that the right ovary was fine except pcos which I already have

Customer:

the left they couldn't view due to the bowel being in the way. My bowels are unchanged since this began. I am regular daily with no constipation or hard stools.

Dr. David :

I see.

Dr. David :

so it sounds more likely to be from the ovary causing the pain

Customer:

would that cause the swelling my groin crease on one side is a lot more indented like I have an abdominal apron on one side it hangs over the groin crease it is very uncomfortable

Customer:

and would that affect the back of left knee pain

Dr. David :

you could have a separate issue like an groin muscle tear or a groin hernia there as well.

Dr. David :

back of the left knee pain most likely is from a pinched nerve

Dr. David :

like a pinched siatica nerve pain which can cause pain in the back of the left knee.

Customer:

so would a hernia cause that or is it unrelated, with the raised white cell count and ESR I am concerned as this has been going on since April

Dr. David :

a hernia can cause abdominal pain which is severe if the bowel are trapped inside of the hernia.

Dr. David :

any sort of infection or inflammation can raise WBC counts and ESR

Dr. David :

have you had a CT scan of the abdomen and pelvis? this would be needed.

Customer:

no my gp wont do that until the gynae has done a follow up pelvic ultrasound. He is currently on leave and wants to do it himself which is further delays

Dr. David :

I see.

Dr. David :

that is too bad.

Dr. David :

well, get the follow up ultrasound

Dr. David :

and get that abdominal and pelvic CT Scan as soon as possible.

Customer:

sorry to clarify, so could a hernia cause a swelling that is undefined the only ones I have seen are quite clearly a hernia

Dr. David :

hernias can sometimes be hard to detect on physical exam.

Dr. David :

sometimes ultrasounds can see them.

Dr. David :

sometimes you need a CT scan to look for them.

Customer:

ok. would a hernia or ovarian cyst cause the sciatic pain you were referring to in the knee? And what then is causing the abdominal swelling as it is there so its not a hernia that cannot be seen.

Dr. David :

usually ovarian cysts have to be super super super large to press on nerves.

Dr. David :

some ovarian cysts can produce too much androgen hormone and cause weight gain

Dr. David :

this is called polycystic ovarian syndrome.

Dr. David :

pinched siatic nerves in the sacrum tends to come from arthritis in the lumbar spine or sacrum.

Dr. David :

swelling in the back of the knee can come from poor circulation in the leg

Dr. David :

or a baker's cyst in the back of the knee

Dr. David :

or lymphedema in the leg if the lymphatic fluid is not draining out of the leg properly.

Customer:

I already have a diagnosis of pcos I said earlier but it is only one sided the swelling. ok thanks I suppose I am just going to have to wait for the ultrasound before I can proceed to CT and get answers. Just frustrating as in pain. Thanks for your time.

Dr. David :

I hope the second ultrasound can get a better look at the ovary.

Customer:

thanks me too

Dr. David :

you might need to go on birth control pills to help regulate your hormones and help control your weight more.

Dr. David :

let me know if you have other questions.

Dr. David :

if done for now, please consider leaving positive feedback below the chat box

Dr. David :

we only get credit for helping clients after positive feedback

Dr. David :

http://www.justanswer.com/medical/expert-dr-david/?rpt=3800http://www.justanswer.com/medical/expert-dr-david/?rpt=3800

Dr. David :

is my website if you need to reach me again with other questions.

Customer:

I am on metformin for pcos they don't want to put me on birth control but thanks for the advice

Dr. David :

thanks for using JustAnswer.com

Dr. David :

you are welcome

Dr. David :

has this helped control your weight

Dr. David :

to prevent you from gaining too much weight?

Customer:

yes it has but they put me on it more to get my hormones into a normal range which they now are

Dr. David :

that is good.

Customer:

it is thanks take care

Dr. David :

actually an MRI scan of the pelvis and lumbar spine might be best to look at nerves in your lower back

Dr. David :

to look for pinched nerves

Dr. David :

better than a CT scan.

Dr. David :

but MRI scans can be more expensive than CT

Dr. David :

the NHS has their way of slowly progressing through the scans

Dr. David :

from less expensive to most expensive.

Dr. David :

you are welcome

Dr. David :

don't forget to leave positive feedback below when done

Dr. David :

thanks for using JustAnswer.com

Customer:

ok thanks will suggest to gp. Yes meanwhile the patient is in pain, still lucky to have the nhs so will just persevere!

Dr. David :

hang in there.

Dr. David :

thanks for using JustAnswer.com

Customer:

thanks

Dr. David, Board Certified MD
Category: Medical
Satisfied Customers: 45238
Experience: Board Certified Physician
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