Possible hernia in Los Angeles

[eric401]

Hello All – I was just wondering if I could get some feedback from all you experts and people dealing with this issue.

I’m a 59 year old male and I have non severe pain in the left quadrant under the rib for awhile now. My gastroenterologist thought it might be a hernia so he ordered a CT scan in August of 2015 and the result was: “The loops of small bowel in the left upper quadrant have a somewhat whirled
appearance with apparent rotation and abrupt angulation of the surrounding
vasculature. There are loops of small bowel lateral to what appears to
represent the descending colon The findings are worrisome for an internal
hernia”
My doctor recommend that I find a surgeon immediately, so I found one at Cedars. The CT also showed constipation and the surgeon started me on Miralax and I’ve been regular ever since. He also wanted a colonoscopy to rule out cancer and it was fine. A few days later (September 2015) they repeated the CT and it came back normal. So no hernia on the CT.

I was fine for a few months but now the pain/ache is back and it hasn’t gone away for almost 5 days. I can pass gas and I have no problem with bowel movements every morning.
I just had all blood work done and everything came back normal – including a thyroid panel.

I do workout at the gym a few days a week – but I haven’t since Saturday because I’m a little worried. Working out does not bother me nor does doing sit-ups.

Could an ultrasound or an MRI help detect something like a muscle tear?

Any help from you guys would be greatly appreciated. I have the CT scans and the film in my possession.

Thanks in advance.

[drtowfigh]

Possible hernia in Los Angeles

An internal hernia is not a muscle proble. It is internal and within the loops of intestine. They are more commonly seen among those who have had surgery in the past or a bad trauma. They can occur without surgery as well but they are rare

Similar to other hernias, intestines can go in and out of the hernia hole. Internal hernias must be repaired. The consequencd of not repairing them can be serious.

[eric401]

Possible hernia in Los Angeles

Dr. Towfigh,

Thank you for responding. You’re awesome for doing this.

The second CT scan came back with this impression: “No CT finding to explain the patient’s abdominal pain. Compared to August, the whirled appearance of the small bowel in the left upper quadrant is less apparent on today’s examination.”

I have both of the CT scans if you’d like take a look at them. 🙂

Do you think I should have another CT scan?

Thank you so much!

[eric401]

Possible hernia in Los Angeles

Can any of the doctors answer this question? I’d really appreciate it.

[sngoldstein]

Possible hernia in Los Angeles

You don’t need any more studies. You need a laparoscopy to look at the bowel and divide the adhesions that are causing the problem. If this is congenital it is indeed rare, but I have seen it before. Find a skilled laparoscopic general surgeon with an open mind.

[Chaunce1234]

Possible hernia in Los Angeles

The likelihood of an internal hernia if you have not had previous surgery is extraordinarily low. The real question is whether or not the CT finding from the first scan had anything to do with your symptoms. It is impossible to know. The most definitive way would be a diagnostic (and hopefully therapeutic) laparoscopy as Dr. Goldstein suggested. Only you can determine if the risk/benefit ratio is appropriate. Generally speaking, the potential risk is low, and the potential benefit is moderate. You however are not a statistic, and these estimates won’t predict what will happen for an individual. Hope this helps!

[eric401]

Possible hernia in Los Angeles

Thanks to all that responded to my question. Really appreciate you taking time out of your day.

[eric401]

Possible hernia in Los Angeles

Can you guys please recommend a laparoscopic general surgeon in the Los Angeles area that accepts insurance?

[drtowfigh]

Possible hernia in Los Angeles

All the laparoscopic surgeons in Los Angeles that I know accept insurance.

Which part of town do you live in?

[eric401]

Possible hernia in Los Angeles

I live in Valencia, but I can travel to Los Angeles.

Thanks again.

[drtowfigh]

Possible hernia in Los Angeles

I’m happy to see you. Also Dr David Chen. You just need a doctor who listens. Most laparoscopically trained surgeons can handle this.

[eric401]

Possible hernia in Los Angeles

Thanks for the information. I had an MRI (with contrast) last Saturday and it didn’t show an internal hernia.

Another question: Would lifting anything heavy cause an internal hernia to hurt. I was fine for about a week, and then Sunday I lifted something that weighed about 50 lbs and I felt it immediately on the left side of my abs (under left rib) and now the next day it’s still hurting.

Thanks for your help

[drtowfigh]

Possible hernia in Los Angeles

Internal hernias are unrelated to abdominal abs use.

[eric401]

Possible hernia in Los Angeles

Dr Toyfigh you do not accept my insurance.

So if it’s not an internal hernia what else could be causing the pain? MRI and CT were normal.

Thank you for your time.

[drtowfigh]

Possible hernia in Los Angeles

Based on your symptoms, I would recommend that you be evaluated by a laparoscopic specialist in abdominal surgery and have your MRI/CT scan reviewed by that surgeon. Either the imaging was misread or it did not catch the internal hernia, as it is may be an intermittent internal herniation.

Most internal hernias are treated surgically based on history. Imaging is only helpful if it shows the internal hernia. A negative imaging study does not rule our an internal hernia.

[eric401]

Possible hernia in Los Angeles

I have an appt. with Dr Chen @ UCLA tomorrow.

Thank you Dr Towfogh – Dr Goldstein and Dr Earle. I will post the results of my visit.

Thanks again!

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