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Occult or hidden hernia?
I suffered a blunt force trauma injury all the way across my lower abdomen in August of 2013. I have had a CT scan with contrast, lying down and an abdominal ultrasound, lying down. Neither showed anything in the MD’s and surgeons opinions. I was told pain I was feeling was pelvic, so I went to my ob doctor. She performed a pelvic ultrasound also lying down and determined that in her opinion pain was indeed abdominal and not related to female organs. I was then referred back to my PCP who is treating me for nerve damage with 300 mg of Gabapentin twice a day. This enables me to function but I still have pain. I have burning , pinching pain like you described in your article about Ms. Sweet. I also experience more pain with a full bladder or when I sit upright in a car seat for too long. I can no longer do my Treadclimber which has caused me to gain 60 lbs. since injury. I am seeing another general surgeon in a couple of weeks who I have been told is a good listener and “thinks outside the box”. I want to show him your article on hidden hernias and also Dr. Deborah Metzger’s article on occult hernias in the hopes that someone will listen to me and I can get relief. I have also seen a gastroenterologist and orthopedic soft tissue specialist neither were of any help. Any advice?
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6 Replies
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Occult or hidden hernia?
– MRI is much better than CT to detect abnormalities in the muscle and soft tissue. I recommend it.
– injection therapy may be helpful as a diagnostic and possibly therapeutic modality. Be careful that any steroid injection, if performed too superficially, may cause fat necrosis and a permanent deformity of your skin. Discuss this with your Pain specialist. -
Occult or hidden hernia?
I thought my appointment was successful in the fact that I now have a treatment plan for my pain. CT scan and ultrasound showed scar tissue but surgeon felt that removal would create more scar tissue and would do more harm than good removing. The CT scan did not show any tears and in his opinion their isn’t anything surgical to be done. I asked about an MRI like you explained and he did not seem to think it would give him anymore information than the CT scan had. He has referred me to a pain management doctor who is going to do injection therapy at sight of pain. He said I more than likely have scar tissue and nerve damage at sight of blunt force trauma. I do not know anything about nerve damage and I still wonder if that and nerve damage could create the level of pain that I feel and when and where I feel it. I also do not understand why in his physical exam he felt two masses to the right and left of my umbilical area but those did not show up on CT scan. Could that be scar tissue? I am going to try the pain injection and hopefully I will get some relief. Any thoughts?
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Occult or hidden hernia?
Hi there.
Please let us know how your appointment went with the doctrine in Indianapolis.
Your pain may be due to a tear in the muscle or fascia with or without nerve injury. Treatment is usually nonsurgical. Nerve blocks should help. If severe and debilitating, local exploration and repair of a tear or cutting the nerve may be helpful. In the meantime, wear no compressive belt etc over the area.
MRI with Valsalva (pushing belly out) is most sensitive study to detect such a tear.
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Occult or hidden hernia?
I also have a burning searing pain that is on the right and left side of abdomen directly where the clip board struck me. This is the nerve pain my PCP is treating me for. After the CT scan with contrast came up normal, the insurance dropped it as a workman’s compensation case and I have been back to full duty work with lots of lifting and standing for prolonged periods. This all seems to aggravate it and cause me pain. I have been on my own since last October trying to find a diagnosis. The article in the New York Times – “In Women, Hernias May Be Hidden Agony” is the only information that I have come across that matches my symptoms. What procedures can I ask my General Surgeon to perform to get a correct diagnosis? How should I handle my appointment? I do not want him to be off put or insulted if I suggest a hidden hernia, however I am very frustrated and so tired of being in pain. Any suggestions for how to conduct my office visit?
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Occult or hidden hernia?
I was operating a stand up forklift with a stationary clipboard which was about inch to inch and a half thick and made of compressed plastic bolted to the top of forklift at about waist height. I did not realize forks of forklift were not all the way to the floor and was going about 30 mph when I hit a pallet and impact caused the clipboard to strike my stomach, causing a severe bruise in abdominal area all the way across stomach about belly button height. ER doctor said it appeared similar to bruising as if from seatbelt if it had been an automobile wreak. ER doctor did suggest small tears in abdominal wall and noted in ER notes but every doctor I have seen since seeing him dismisses his opinion. Pinching pain I feel when sitting in upright for too long is hard to describe it ranges from a stabbing pain to heavy feeling of pressure. It presents mostly on right hand side when sitting upright. Almost like I swallowed a large rock and it is sitting on my intestines or bowels. If I cannot get anywhere with this surgeon that I am about to see in Indianapolis I would really like to come see you. When I read your article about Ms. Sweet, I thought to myself,” That’s it!, that is the pain and symptoms I am feeling!”. Thank you for your time. I think this forum is fantastic!! Doctors just do not seem to think woman can have hernias and if you do not have a bulge they completely dismiss you as being either crazy, having female issues or in my case that I am overweight and that is causing your issue.
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Occult or hidden hernia?
Please explain the exact blunt force trauma. Your story may be suggestive of a hernia. Where exactly is your pinching pain?
Also, a physical exam which shows point tenderness in your groin where a hernia would be is a great start. If your surgeon can feel a hernia, or even elicit tenderness in the area, I would have your scans re-read. Or do a dynamic study where you are pushing out (ultrasound or MRI).
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