[jzinckgra]

Surgeon challenging Radiologist’s CT scan

quote :

jzinckgra, indeed I am only a patient as well, but to me your CT report seems very detailed and specific. I personally have never had a report even close to that detailed but it probably depends on the radiologist and how much they feel like investigating and reporting.

With that said I do know it is a very common belief of many doctors and clinics to think that if you do not have the big bulge than you do not have a hernia. On the other hand there is a lot of evidence on this forum and elsewhere to suggest that is not always the case.

Interestingly, I do have a bulge, but it is one of fluid, not fat or intestine. It comes and goes depending on body position. Earlier US report said possible communication between peritoneum and scrotum or vice versa. Nobody seems to know where the fluid is coming from, but seems obvious and likely it has something to do with herniated fat.

[jzinckgra]

Surgeon challenging Radiologist’s CT scan

quote :

jzinckgra, I don’t think it is uncommon to have interpretive disagreements between radiology and doctors, I have personally encountered this as well and as a patient it can be very frustrating to be on the receiving end.

You might want to consider getting a second look at the images, and also find out if the surgeon themselves looks at the images. Many doctors go based on the written report alone which is fine in many cases but with some of the more obscure situations it may not be as helpful, particularly if you do not have the traditional palpable hernia bulge. Find a hernia expert if possible, or at least a doctor with a lot of experience with hernias.

I think Dr Towfigh of these forums used to offer an online consultation service where she would personally review images, perhaps that could offer some insight as well.

thank you. I am waiting for a referral to another surgeon. My current surgeon did look at the images and came away with a different interpretation. My frustration in part has to do with the physical dimensions that the radiologist was able to make. If she had just stated there was an “discontinuity of the abdominal wall” and nothing more I could see how that may be open to interpretation. However, the report states dimensions plus “herniation of fat”. Seems conclusive to me, but what do I know.

[jzinckgra]

Another hernia 4 weeks after repair?

So I went back to surgeon yesterday and he is stumped and ordered an ultrasound. He poked and prodded and is convinced there is no hernia, but said it’s possible but unlikely. To confirm , he did in fact perform the TEPP procedure, so any fat that may have been in the way during surgery was removed to visually confirm absence of hernia. He said it could be inflammation of the vas deferens.

[jzinckgra]

Another hernia 4 weeks after repair?

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As soon or as late as you wish. Your prior surgery likely has not affected what surgery you may need on the symptomatic side.

This is so frustrating to think the Dr. missed the other hernia. He basically had three opportunities to check: once during consultation, once during surgery and once post-op. Each time he is certain there isn’t one there. I’m a bit embarrassed to call the office and make another appt. and have him take a look again. It’s odd cause some days, like today I can feel the pressure and discomfort and other days all is well.

What’s the best way to approach this with him? Don’t mean to criticize his judgment, but there doesn’t seem to be anything other than a hernia to explain this. Is it possible it is residual fluid or inflammation from him poking around down there? Thanks again.

[jzinckgra]

Another hernia 4 weeks after repair?

quote :

Depends on how your hernia was surveyed laparoscopically.
Some hernias are filled with fat and a survey from the inside will not reveal a hole (aka a TAPP or transabdominal laparoscopic survey) while there really is a hole/hernia.
If your surgeon took down that fat and actually looked at the muscle to see if there is a hole (aka TEP or extra peritoneal laparoscopic survey) then there is no better more sure way of ruling out a hernia.

I don’t believe he took the fat down, but not sure he would have told me if he did. Last couple days have felt/looked fine, but probably cause it’s not popping out. If there was another hernia, how soon could that one be surgically fixed? thanks for your reply.