• Hernia Discussion

  Recommendation in USA (South)

  Posted by Côme on January 27, 2025 at 3:55 pm

  Hello,

  This is a follow-up of this post ( https://herniatalk.com/forums/topic/mesh-less-repair-after-8-month-disaster/ ).

  Long story short : Surgery in February 2024 with Dr Conze, no mesh, technic Minimal Repair. Post operative pain very very high. March start to have huge digestive issue (permanent stasis of feces near hernia site, leading to infection / fever). Ultrasound shows nothing. Colonoscopy shows nothing coherent. MRI result was incongruous.

  Gastro-enterologist hypothesis : Crohn.

  Took treatments, changed diet to a very low residue diet, 0 sugar : no result.

  Gastro-enterologist doesn’t believe anymore that it’s Crohn : it doesn’t respond to any treatment and the results are incongruous :

  Moderately elevated calprotectin (100-158)
  Absence of typical granulomas or ulcerations
  Inflammation described as mild
  Absence of characteristic skip lesions
  Normal CRP outside of crises

  Just like I told them from the beginning, it’s not Crohn or classic IBD. It’s the surgery that messed up something. I have a few hypothesis :

  Hypothesis #1 – Post-surgical neurogenic dysfunction:

  Surgery may have altered local digestive innervation
  Would explain localized motility disorder
  Consistent with stasis and secondary infections
  Compatible with worsening during effort

  Hypothesis #2 – Post-Surgical Anatomical Defect or Adhesion :
  Rationale: An anatomical defect like a tear or adhesion might have formed post-surgery, leading
  to mechanical stasis of bowel contents. This could explain the localized pain and the inflammatory
  cycle due to retained fecal matter.
  Supporting Evidence: The progressive nature of symptoms, particularly the sensitivity and pain
  with physical effort, suggests a mechanical issue at the site of surgery.

  He recommended me a few tests such as “Nerve hydrodissection” (as I still have weird feeling there), “Barium transit with videofluoroscopy”, “Dynamic abdominal Ultrasound and/ or MRI”, “Colonic manometry”.

  Where I’m now (in Central America), they don’t provide this kind of examination.

  I’m looking for recommendation, I need someone to take my case seriously (And Dr. Conze doesn’t answer anymore, a real shame !). Could be in the US (South preferably…) or Europe or elsewhere.

  Do you have any recommendation ?

  Côme replied 9 months ago 1 Member · 1 Reply
• 1 Reply

• 

  Côme

  Member

  January 29, 2025 at 4:34 pm

  More specifically I’m thinking of Dallas.

  Any recommendation in Dallas for :

  – Nerve release injection (preferably with saline water solution)

  – Dynamic Sonography / Ultrasound ( https://ajronline.org/doi/10.2214/AJR.06.0579 )

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