Differential Diagnosis
- Single most likely diagnosis:
- Ovarian cyst: The CT scan shows a cyst-like low-density solid lesion in the left adnexa, which is likely to represent a left ovarian cyst, given its unchanged appearance compared to the prior study.
- Other Likely diagnoses:
- Diverticulitis: Although the CT scan does not show evidence of diverticulitis, the presence of scattered diverticula in the rectosigmoid colon increases the risk of developing diverticulitis.
- Adhesions or bowel obstruction: The anastomotic changes in the bowel in the left lower quadrant and the history of previous gastroplasty may increase the risk of adhesions or bowel obstruction.
- Fatty liver disease: The CT scan shows diffuse fatty change of the liver, which may be related to fatty liver disease.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.):
- Ovarian torsion: Although the CT scan does not show evidence of ovarian torsion, it is a potentially life-threatening condition that requires prompt diagnosis and treatment.
- Ectopic pregnancy: Given the presence of a cyst-like lesion in the left adnexa, ectopic pregnancy should be considered, especially if the patient is of childbearing age and has a history of fertility issues.
- Appendicitis: Although the CT scan does not show evidence of appendicitis, it is a common cause of abdominal pain and can be life-threatening if not diagnosed promptly.
- Rare diagnoses:
- Ovarian cancer: Although the CT scan shows a cyst-like lesion in the left adnexa, the possibility of ovarian cancer cannot be entirely ruled out, especially if the patient has a family history of ovarian cancer or other risk factors.
- Endometriosis: The presence of a cyst-like lesion in the left adnexa and the patient's symptoms may suggest endometriosis, although it is not directly diagnosed on the CT scan.