Ovarian cyst
Presentation
Acute onset of intense right-sided abdominal pain. History of giving birth 1 week ago. Referred for an ultrasound to exclude cholecystitis.
Patient Data
No signs of cholecystitis; the gallbladder is thin-walled, not irritated. No stones within 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 inferomedially to the gallbladder.
A unilocular cystic mass with a mildly enhancing wall consistent with an 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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