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Omental Nodules on CTFrom: allanho@aol.comSun Nov 23 23:15:49 2008
56 yo menopausal virgin admitted to the medicine service for right flank pain.? CT showed moderate ascites with a few small nodules on her omentum.? One of the nodules is near the tail of her pancreas.? Her ovaries were not enlarged.? Chemistry & CBC are all normal.? UA has 10-15 RBC and 1+ oxalate crystals.? History and Physical are otherwise unremarkable.? I think her right flank pain is from passing some non-obstructive renal stones.? She is scheduled to have a transvaginal ultrasound in the morning.? The internist is planning to do a paracentesis.? The neareast gyn oncologist is over two hours away.? What do you think of the following options? 1.? Diagnostic laparoscopy & biopsy if the paracentesis is non-diagnostic. 2.? Exploratory laparotomy with a general surgeon with BSO. 3.? Turf her to a gyn oncologist. Allan Central Pennsylvania
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