Does this sound like a Hernia (either abdominal or incisional)??
10/22/2017 at 7:48 pm #11084
Hello, I’m wondering if these sound like hernia symptoms, either abdominal or incisional…
I had a robotic laparoscopic hysterectomy and inguinal hernia repair 6 months ago. I’ve very gradually increased my physical activity since. Four weeks ago, I did my 3rd Pilates class and immediately after this one, I felt a burning “pain” (definitely not muscle soreness) running vertically along midline abdomen, between belly button and sternum, just superior to an incision from that surgery. I felt nausea and swelling in that region for days. Physical activity like jogging or climbing stairs aggravated it tremendously, where I used to do this just fine prior to that class. It made that area feel like things are moving around or separating inside. Ever since the class, I can feel a raised soft area in that upper ab region, though it’s not a defined lump. I had my husband look at it, and he confirmed that he sees something too, so I know I’m not just imagining it.
I’ve done no physical activity for a couple of weeks to rest it, and it was starting to feel better, but a few days ago, I was just catching/throwing a basketball a couple of times and I got a sudden sharp pain in that midline abdomen again. I immediately stopped, but have had that nausea, then the swollen/pressure sensation again in the same upper abs, and it felt like it was kind of impairing my ability to breathe. I was getting light headed while trying to sit at the dining table. All after that little bit of activity.
I saw my General Practitioner, who palpated my abdomen and had me bear down, said he felt something and believed it was an incisional hernia (even though it is just superior to the incision). He ordered an abdominal ultrasound, which turned out to be normal, “anterior abdominal wall demonstrates no evidence for hernia, mass or fluid collection”, just a simple right renal cyst. Although my last repaired inguinal hernia was also not found on 3 different imaging tests, so do I have reason to be skeptical? Blood & urine work normal, except slightly low RBC Count and slightly elevated MCV & MCH. (I did not have anemia after the surgery, so he was a bit puzzled by these blood results, and said to just monitor them). I do notice being fatigued when my abdomen is aggravated. After the normal US results, he said if it is hernia, then it could be a very small one then.
During the abdominal ultrasound, the tech did have me bear down when she was trying to check the painful area. But just wondering if this makes a difference… she seemed to be positioning the US head just under my ribcage, which was superior to the location of the swelling and painful region, not actually on it. I pointed to a lower spot, but she’d say that if it’s intestines, you can’t see that with US.
I also saw my Obgyn surgeon and when I asked her about a possible incisional hernia, she said right away that the incisions look fine, that with the robotic laparoscopy, there was not a deep cut and no suturing required. Everything looked fine from her perspective, though she did not feel or press on my upper abdomen like my GP did, and I was lying on my back so my abs looked flatter. (I think she was mainly concerned about my pelvis and my 6 month post-op checkup.) It sure doesn’t feel fine. After her surgery 6 months ago, I had a terrible skin reaction to the Dermabond used to close the incisions and she had me peel it all off at 5 days post-op. That 1 particular incision wept and itched for at least 1.5 months.
Not knowing what’s wrong, when you feel something is not normal, is no fun. This happened with my undetected inguinal hernia for months. So I am so thankful for having found this forum and Dr. Towfigh’s articles. Thank you in advance for any insight!
10/22/2017 at 8:23 pm #15179
I forgot to add that during the abdominal ultrasound, the tech did have me bear down when she was trying to check the painful area. But just wondering if it makes a difference, she seemed to be positioning the US head just under my ribcage, which was superior to the location of the swelling and painful region, not actually on it. I pointed to a lower spot, and she’d say that if it’s intestines, you can’t see that with US. My General Practitioner also had me bear down while lying down, and he said he could feel “something” when he initially said it’s a hernia. After the normal US results, he said if it is hernia, then it could be a very small one then.
12/09/2017 at 11:40 pm #15279LeviProcterMember
It’s likely a trocar site hernia. This is the same as an incisional hernia.
I would put money on it.
12/15/2017 at 1:29 am #15301
Thank you for your response Dr. Procter. Since that post, I saw my General Surgeon, and based off the same normal US report (not the images) and a manual exam, he didn’t think there was any hernia, but said it was possible that a small one could be “”brewing””, and then he’’d see/feel the lump he’’s looking for. He did say I have a diastasis (I’ve never been pregnant) and the bulge that I felt could just be scar tissue from the last surgery. He felt I should be able to slowly resume Pilates and my GP felt I should be able to still jog.
I’ve been resting and doing no exercise for 10 weeks now hoping that would bring healing. Yesterday I tried a light 15 treadmill jog, (no abdominal exercises) for the 1st time in the 10 weeks and I stopped as soon as I felt some nausea in that same upper ab location. I still get some burning pain in the same area if I try like 3 pushups, so I’m not risking trying any Pilates.
12/16/2017 at 6:17 pm #15310drtowfighKeymaster
Hi there. Agree with Dr Procter. It’s a hernia most likely. It can be incisional or epigastric. Either way, it’s usually fat containing and not dangerous. Surgery helps with symptoms.
The ultrasound is usually diagnostic. CT scan can also be helpful.
12/16/2017 at 11:08 pm #15311
Thank you Dr. Towfigh! I just didn’t ’know how I would get further doctor’s orders for a CT scan after my ultrasound report came back normal. I would probably be in contact then.
12/21/2017 at 2:19 am #15338LeviProcterMember
Ultrasound will miss these. CT can also. If you do get a CT then make sure you “bear down” (like having a bowel movement) during the scan itself to increase gut pressure to stretch out increase ability to see the defect.
12/29/2017 at 6:14 am #15367
Thank you Dr. Procter! I appreciate your response and this affirms me to continue to pursue this and to not just settle.
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