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 makes it a possible diagnosis, especially if the patient is presenting with abdominal pain.
- Hiatal hernia symptoms: The small hiatal hernia present in the CT scan could be causing symptoms such as abdominal pain or discomfort, especially if the patient has a history of gastroesophageal reflux disease (GERD).
- Anastomotic changes: The anastomotic changes in the bowel in the left lower quadrant could be causing symptoms such as abdominal pain, diarrhea, or constipation, especially if the patient has a history of bowel surgery.
- 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 life-threatening condition that requires prompt diagnosis and treatment.
- Ectopic pregnancy: Although the CT scan does not show evidence of an ectopic pregnancy, it is a life-threatening condition that requires prompt diagnosis and treatment, especially in women of childbearing age.
- Bowel obstruction: Although the CT scan does not show evidence of mechanical bowel obstruction, it is a life-threatening condition that requires prompt diagnosis and treatment.
- 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 right paramidline uterus and scattered diverticula in the rectosigmoid colon could be associated with endometriosis, although the CT scan does not show definitive evidence of this condition.