Can ovarian cysts cause lower right abdominal pain?

Question

Hi doctor,

I initially experienced severe lower right quadrant abdominal pain, and It subsided on the same day, but it has been painful since then. I consulted one doctor, who diagnosed it as a hernia, but my ultrasound scan showed a big inguinal lymph node instead of a hernia. So I visited a different doctor who suspected my gallbladder was the problem. Again, an ultrasound revealed 2 to 3 mm polyps, but everything else was normal. A hepatobiliary iminodiacetic acid scan was scheduled for me when I finally visited the doctor, who was suspected of my gallbladder. So he advised me for computed tomography. That report showed that I had an irregular rim-enhancing hypodensity in the right ovary, which probably represents a resolving hemorrhagic or corpus luteum cyst. In addition, I have endometriosis and painful and heavy periods. Could this finding of a potential cyst be the cause of my pain? Please help.

Answer 1

Hi,

Welcome to Icliniq.com.

Thanks for your query.

I have been gone through your reports (attachment removed for protecting patient's identity) and still things are unresolved. It would be better if you would send your detailed gynecology obstructive and medical history.

Do you have a history of missed periods or unprotected sex?

Do you have any history of vaginal discharge with foul smell, irritation, or itching?

Regarding gynecology and your question regarding resolving the hemorrhagic cyst, it could cause pain as it is resolving very tiny and on the right side, not on the left. You can have another suspicion that needs to resolve, like excluding any pregnancy, especially ectopic pregnancy, ovarian cyst torsion, any recent bleeding or rupture of the cyst, endometriosis in the ovary or rupture of ovarian endometriosis, etc. But, still, in all possibilities, the pain would be one-sided lower abdominal and too severe if it is like that, then you need to report urgently to the tertiary care gynecology emergency.

I suggest you take a serum beta human chorionic gonadotropin blood test to check your pregnancy status. If the results are positive, then a quick transvaginal scan and repeat beta-human chorionic gonadotropin test after 48 hrs to check its progression. If it shows an increase of less than 60 %, it is alarming, and we need to evaluate whether it is an ectopic pregnancy outside the uterus.
Have a transvaginal scan with expert hands to exclude any local emergency.

For endometriosis or other gynecology emergencies, diagnostic laparoscopy is the gold standard, and during laparoscopy, a ruptured or torsion cyst could be removed.

Please follow up for futher assistance.

Thank you.