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2 different ct scans 2 different diagnosis?
Hi, I had posted previously about some weird symptoms I had which led to an ER visit and a CT scan which said I had a bilateral inguinal hernia containing fat. I am unable to post in that topic for some reason. My PCP about 3 days later did a full blood workup and the only out of ordinary was a high ferritin level. I went to a Dr Naim from the Advanced Bariatric Center in Los Angeles for a free consultation(other unnamed surgeons have a VERY high fee for just a simple consultation with out of network insurance or no insurance).
Dr Naim did an physical exam(finally someone actually did this) of the inguinal canal through the testicles and concluded I have very small hernias and not to do anything about them if there was no symptoms, he said the CT scan was bulletproof case closed. I have no bulges. Well come the last few days I’ve HAD to move for new construction at the place I was living, and it was arduous for me. Lots of lifting and straining.
I’ve settled into my new place and really started feeling terrible at night when I lay down especially and have had on and off nausea and constipation, high heart rate as well as excruciating pain at times. This morning I had a hard to pass stool and had to strain and when I got up I felt terrible, shaking, disoriented and lower abdomen pain. I went to the ER in my new town and they did a NEW CT scan as well as chest xray. ER DR SAID NO HERNIAS. I was still in pain when discharged and given a script for EIGHT pain pills, gee thanks, no wonder people get this stuff on the street. So now I’m left with this pain on and off and possible strangulation or death with no way to know what’s going on. Why an MRI or other wasn’t done is beyond me especially since I told the ER dr about the previous, by a month, ct scan and the inguinal hernia diagnoses. Any experiences or suggestions about this would be greatly appreciated.
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4 Replies
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Sorry, no names of specialists I can provide in Utah.
CT scans are often misread, especially if the report says no hernia. They are wrong the majority of the time. We reported this back in 2014 (https://www.ncbi.nlm.nih.gov/pubmed/25141884) and have a followup paper coming out this year on the same issue.
Examination by an expert, correlating your symptoms with their knowledge of hernias, is what you need. Nausea can be a symptom of hernias. Ear symptoms are not related.
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Forgot to mention that after my move, almost any lifting makes me feel nauseous and pain lower abdomen. Seems it would be indirect inguinal hernias more than digestive to me. I’ll see what a local surgeon thinks, but there are no hernia specialists in Southern Utah that I know of only generalists.
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Hi thanks for the response. Well my symptoms are nausea with no vomiting, awful lower abdomen pain, a ringing or rushing sound in my right ear and constipation that comes and goes, sharp pains at times roughly where indirect inguinal hernias would be, switches from lower right to lower left but mostly lower right abd. also some pain near the heart or transverse colon.As a note I did just have to move and did do a lot of lifting and bending it was pretty terrible. This comes and goes making it hard to know what to do. I’m thinking of getting another consult with a different surgeon to get another physical exam and look over of the CT scan cd. Failing that I’m going to push to get a colonoscopy or at least ultrasound. Again I have no obvious bulges and no groin pain.
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Speaking from experience, you can often have 2 different people read the exact same CT and report 2 different things. My understanding is that inguinal hernias and/or fat in inguinal canal (lipoma etc) are fairly common and so sometimes they’re just ignored. Also, a lot of clinicians will just read the CT paper report and not look at the scan themselves, since reading radiology is complex and a field in and of itself. Yet another reason why specialists can be helpful.
Perhaps focus on your specific symptoms, and then go from there. Where do you have pain? What makes the pain better or worse (if anything)? Are the symptoms consistent with an inguinal hernia or something else? What did Dr Naim suggest regarding your symptoms?
You could always get an ultrasound with valsava on the groin, it’s usually a fairly cheap procedure and can also help to diagnose otherwise difficult to detect hernias.
Good luck and keep us updated on your case and decision making.
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