Question: My 19 year old has had lower abdominal pain for several months. She also has lots of gas and bloating and thinks it is related to gluten. Just this week she has palpated a lump above her lower right inguinal area that seems rather soft than hard and about the size of a hen's egg. She describes the fullness as extending up to her waist. Today, she described the pain as 3 to 4 on a scale of 10 with pangs now and then that are excruciating. I checked her abdomen for "rebound tenderness" (appendicitis?) by pushing and then releasing over the area that hurts. She did not notice more pain from that. She also says that her pain is worse when she stoops or bends down. She also has had a shunt that drains into her abdomen from her head, since she had spinal meningitis as a baby. A sonogram sometime back indicated extra fluid in the lower abdomen spaces. What advice for further care or diagnosis would you give? Does this sound like an emergency? We have a doctors appointment scheduled Monday with a Women's Clinic. Thank you

Thank you for your reply.
We have been trying to use a gluten free diet and to avoid sugar. But with Easter she did not stick to her diet. She does use gluten free protein bars. Had not thought of this lump being a lymph node. Which leads me to wonder. Might it be lymphoma? What would those signs be? And how would that be tested? She has been very tired. No fever that I have noticed. Also, would you be concerned about appendicitis? Ovarian cyst?