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Done with CT of abdomen. What are the findings from the report? Suggest further treatment?

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Gastroenterologist
Practicing since : 1996
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Hi This is XXXX from Chennai.
my latest CT abdomen/pelvis scan report says like:

Liver - no focal lessons or IHBRD
Spleen - nil significant
GN - no radiodense calculi
Pancreas - nil significant
Adrenals - nil significant
Kidneys - nil significant
Bowel, mesentery, omentum- nil significant
Lymphadenopathy:
a) greater omental - nil significant
b) lesser omental - nil significant
c) mesenteric - 5mm, nil significant
d)diaphragmatic - nil significant
e) para-aortic - 6mm, nil significant
f) para-iliac - nil significant
FLUID - NIL
BLADDER - nil significant
PROSTATE & Seminal Vesicles - nil significant
Inguinal Orifices : right indirect inguinal hernia with omental fat as content
Abdominal Wall : minimal silver of fluid in the region of the umbilicus, there is no intraperitoneal extension

Please explain the above report for my clear understanding and what should I do further??
Posted Tue, 12 Nov 2013 in Digestion and Bowels
 
 
Answered by Dr. Ratnakar Kini 1 hour later
Brief Answer:
Detailed answer given below

Detailed Answer:
Hi XXXXXXX
Thanks for posting your query.
I am Dr.Ratnakar Kini and I am pleased to assist you.

As per your CT scan report, you have right inguinal hernia. And your hernia is having fat as its content. Rest of the study does not show anything significant.

Let me explain to you what inguinal hernia is.
Inguinal hernia is a condition in which the abdominal contents come out through a opening near the groin area called the inguinal ring.
It starts as a small swelling. But over a period of time, it may increase in size and may descend in to scrotal sac ( the one that contains the testes). Conditions which increase the abdominal pressure like straining during bowel movements, coughing and lifting weight increases the size of hernia.
Hernia forms a sac and it can have part of intestine, fat etc as its content.

Now let me tell you about the complications of hernia.
When you lie down or push the hernial content back in to abdomen, the hernia decreases in size. It is called reducible hernia.
But sometimes, it stays back and is not reducible and get obstructed causing Obstructed hernia. Due to this, the blood supply may get cut off and it is called strangulated hernia. These are EMERGENCIES and need immediate medical attention.

Surgery is the only curative treatment for hernia. So your hernia has to be treated by surgery. If your hernia is very small, you need to avoid straining to prevent the hernia from increasing in size. If you are constipated or having chronic cough, get treated for that. Avoid lifting heavy weights.

Which part of Chennai do you stay?
You can consult me at Velammal Hospitals, Mugappair.

Regards,
Dr.Ratnakar Kini
Above answer was peer-reviewed by
 
Follow-up: Done with CT of abdomen. What are the findings from the report? Suggest further treatment? 1 hour later
Hello Doctor,

Thanks for your timely consultation. Surely I will come and XXXXXXX you in person as soon as I get time.

The reason being I took the scan test is I noticed some blood was coming out from the umbilical part (belly button) last week along with some white fluid. Then I went Christian medical college hospital (Vellore) for consultation. Initially the doctor checked on that part and since he couldnt spot any external injuries, he adviced me to take up the CT scan and his appointment is on monday. I just thought it would be nice if I get second opinion and hence I landed up here. Thanks once again. I would like to know the reason for that problem also doctor.

Abdominal Wall : minimal silver of fluid in the region of the umbilicus, there is no intraperitoneal extension

Is that blood and fluid coming out near umbiculus because of hernia or some other reason ? Is surgery a only way to cure hernia?? Does I have anything to do externally like jogging to remove that fat content ??
 
 
Answered by Dr. Ratnakar Kini 16 hours later
Brief Answer:
Detailed answer given below

Detailed Answer:
Hi XXXXXXX

As per the CT scan report, there is only minimal fluid collection in the belly button area.
The doctor had advised for a CT scan to see if there is any collection of fluid inside the abdomen that is coming out near your umbilicus.
Fortunately, there is no such thing and you have only minimal fluid collection in the superficial area which could probably be due to infection.

The blood stained discharge coming out near your umbilicus is not related to hernia.
Yes, surgery is the only treatment that gives permanent cure to hernia. But avoid straining to prevent the hernia increase in size.

I have put it in simple term as fat. It is actually called omental fat. Omentum surrounds the abdominal content. Jogging will not remove this fat.
You need to push it back in to abdomen along with the hernial sac and tighten the inguinal ring through which it has come out. This is what is done during surgery.

Let me know if I can assist you further.
Regards,
Dr.Ratnakar Kini
Above answer was peer-reviewed by
 
Follow-up: Done with CT of abdomen. What are the findings from the report? Suggest further treatment? 4 hours later
Hello Sir,

Thank you so much for your time to assist my health. So I have got clear understanding of what I have to do now. I will do that surgery soon.

And one final thing I would like to know is still I saw some blood when I inserted a cotton bud near umbilicus. Is that due to infection?

And also as I come to know that you are an Gastroenterologist, would like to have your valuable opinion about another part of my health problem. I tend to get gas trouble easily even If I have any little amount of gastric foods like potatoes, Chenna, dhall etc. Since Some of the foods I'm taking on daily basis has gastric in it. I had to take medicines like gasex for the remediation. I would like to know whether it is curable or is there any major/minor problem with in me or is it because of heredity as my mother also has the same problem? Does this problem requires your direct consultation? If yes, please provide your contact number.

Thanks in advance.

One more important thing forgot to ask , Is the hernia surgery is safer/harm to do ? I'm planning to do that in Cmc hospital, Vellore as it is my hometown. Is that hospital is dood/safe for that surgery??
and how many days I need to take rest after the surgery and what should I do after the surgery. You may knew that we need to travel a lot in bus and train for office.
 
 
Answered by Dr. Ratnakar Kini 2 hours later
Brief Answer:
Detailed answer given below

Detailed Answer:
Hi,
Yes, infection could the cause.

For your gas issues, try to avoid gas forming food items including lentils.
You can also take digestive enzymes.
It is only a minor issue.
No it is not hereditary.
Since you are planning for surgery at CMCH, you can consult the doctor there itself for prescription.

Hernia surgery is a commonly done surgery and is very safe. CMCH is a reputed hospital and you can get your surgery done there without any second thoughts.

It depends on whether you have a lap surgery or an open surgery.
If it is a lap surgery, you can return for work within a week.
If it is open surgery, you can return to work in 2-3 weeks time.

Let me know if I can assist you further.
Regards,
Dr.Ratnakar Kini
Above answer was peer-reviewed by
 
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