Ovarian mass with gall bladder stone reported in young female patient, this case support the ovarian gallbladder axis theory

A 33 years old female patient presented to our ED for epigastric pain and lower abdominal pain , the pain was almost in left side with tenderness on right side . The patient had multiple visit before to primary health care for lower abdominal pain and epigastric pain , she got many of medications but no improvement . She had regular menstruation, last menstrual period was 15 day before that visit to our ED . Blood test was requested that showed normal liver , renal and pancreatic function , only she had mild elevated in WBs about 11000 and mild elevated in CRP about 17 . At that time , the patient still has had lower abdominal pain and epigastric pain , SO CT abdomen requested to rule out acute appendicitis.The CT abdomen Showed :gallbladder stone and right ovarian large cystic lesion with solid component , free fluid intra abdomen and no appendicitis . The ultrasound abdomen requested for more details about the cystic ovarian lesion that showed : Right adnexal cystic lesion with solid component / right ovarian hemorrhagic cyst with retracting clot. Minimal ascites. Uncomplicated cholecystolithiasis . tumours marker requested that was much elevated . The Patient flew back to her country for medical management up on her request