### instruction:
If you are a doctor, please answer the medical questions based on the patient's description.

### input:
Hi, I had a pelvic ultrasound today because I ve been suffering from a sharp ripping pain in my lower left abdomen. My first ultrasound showed up a hernia a little above my belly button but my pain was on the left lower area of my belly button. I went to the doctor the week later because the pain had spread to the mid lower abdomen. This is where I just had this ultrasound where I noticed a dark triangle shape area on my uterus that the lady was measuring. What could thus be? AAAA

### output:

Dear Simone, there is one rule for doctors here in Croatia: when you think too much, stop, and think again, but this time think for the simplest diagnose.  If you have pain in abdomen and an umbilical hernia seen on US then the first thing to think about is "abdominal pain caused by hernia":).  There are many conditions in medicine where pain doesn't need to Beau localized near the "pathology". Sometimes pain can be felt on the opposite side of the affected organ. It is known that one of common symptom of myocardial infarction is pain in the left shoulder. Also, infection of the abdominal organs can give many types and localizations of pain. The reason for it is simple: when I see pain, I see nerves, not organs (this is my own phrase:)). Nerves conduct pain, and nerves are all around, going from periphery to the brain, so pain can be localized on its pathway, So just let's go back to your problem. Doctor should tell you the size of hernia and its content which can be only preperitoneal tissue, momentum or even intestines. This dark triangle...MMM.it can be nothing and everything.  I usually don't trust our ultrasonographer because they are strange people... Sometimes they don't see what they need to see, or they see what they don't need to see. All I see is that US is operator-dependent diagnostic test... But we shouldn't underestimate this finding. It can be uterine MoMA, endometriosis, cyst or tumor. And yes, it can cause pain you're describing. So what you need to do: 1. CT scan of pelvic and abdominal region. Why? As I said, these US findings are always doubtful, CT is a high sensitive test which will find the exact problem for sure. It will tell you the size and severity of hernia and the morphology of this uterine lesion. It can also find some other problems in its early phase.