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Re: Omental Nodules on CTFrom: Dr. John Provatopoulos B.Sc. M.D.C.M. F.R.S.C. (johnprov@sympatico.ca)Mon Nov 24 03:06:15 2008
At Mon, 24 Nov 2008, allanho@aol.com wrote: > >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 You must have a really good CT machine, its not urgent send her to Gyn Oncoloogist with experience in doing Laproscopic omentectomies.
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Take care, John
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