Ovarian cyst
Presentation
Previously healthy 29 year old woman, giving birth one week ago, acute onset of intense right-sided abdominal pain. Referred for ultrasound to exclude cholecystitis.
Patient Data
Ultrasound examination shows no signs of cholecystitis, the gallbladder is a thin-walled, not irritated, no stone, and no surrounding inflamed tissue.
If the radiologist had looked carefully in addition to the gall bladder, he / she could have noticed the hypoechoic change down and medially to the gallbladder.
Contrast-enhanced CT scan shows a unilocular cystic mass with a mildly enhancing wall
Ovarian cyst.
Case Discussion
Radiologist examined only the gallbladder and liver area trying to answer the single question which the referring physician had written, namely cholecystitis, but the radiologist should examine the entire abdomen of the patient to rule out other causes of the acute abdomen.
The patient was escalated to CT Abdomen as acute abdomen didn't subside. CT scan showed an ovarian cyst which could have been detected at the first ultrasound examination, and could have saved much time, money, and radiation.
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