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Hi i had surgery 8 months ago to remove a

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Posted on Tue, 19 Feb 2019
Question: Hi i had surgery 8 months ago to remove a hemingioma in my liver. They removed the left lobe and the gal bladder.

I have a problem with the shape of my upper abdomin after surgery. It sticks out in a weird way. Ultrasound revealed no incisional hernia.

I am confused as why my body looks this way now. I would like to post a picture so that you understand the situation.
doctor
Answered by Dr. T Chandrakant (1 hour later)
Brief Answer:
Please give details and post actual photographs as requested for.

Detailed Answer:
Hi.
Thanks for your query.
Noted the history well, seen the 2 photos in lateral views and understood the concerns.

Please provide additional information for me to assist you better:
Your age and gender please.
Please post front view photos, also showing the incision taken for surgery.
Did the bulge appear soon after surgery, say noted after you started moving around or late?
Does the bulge increases on coughing or straining?
How does it looks like on laying flat in bed and trying to lift head and legs simultaneously on bed. Please post all such photos.
Does the bulge increase or reduce on trying to retract the abdominal wall like straining?

Any symptoms like pain?
Any other information please.

Awaiting for your feedback and all photos.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. T Chandrakant (14 minutes later)
I am 39 male.

First few months I believe it was better. It got worse last 4-5 months.

On coughing nothing sticks out. When i strain the muscles it looks better. Ultrasound showed no hernia.

When lying flat on bed it looks good. I noticed when i do excericise (planks) it looks like its loos and falling out (im attaching a picture of it when I do a plank.

doctor
Answered by Dr. T Chandrakant (50 minutes later)
Brief Answer:
As explained.

Detailed Answer:
Thanks for your feedback and fresh photos.
There is a mid line incision.
Seen the additional photos and history.
This has gradually worsening.
Your finding that it looks loose and falls out while doing plank indicates that both the recti muscles have become flabby.
This has occurred most probably due to lack of or reduced use/exercises.
There is usually no denervation of these strap muscles on mid line incision. Hence the possibility of denervation causing flabby muscles is least.

I would advise you the following in such a situation:
It is already 8 months of surgery hence the scar is getting well matured. You may please go ahead with rectus strengthening exercises and see the results. Suggested one is to raise the head and legs simultaneously in laying down position.
This is surely not a hernia as the hernia increases on coughing or straining and is reducible on clinical examination. This is more like proptosis.

Repeat high resolution Ultrasonography for the affected muscles can show the health of the muscles.

I hope this answers your query and helps you.
Please give feedback and feel free to ask further relevant queries if there is a gap of communication.


Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. T Chandrakant (28 minutes later)
Thank you. I do agree with your opinion.

So is what I have diastasis recti? Do you think exercise alone can fix this?
doctor
Answered by Dr. T Chandrakant (8 minutes later)
Brief Answer:
No diastasis - looks to be flabby muscles

Detailed Answer:
Thanks for your appreciation.
No diastasis - in diastasis rectus the two recti are separated.
It looks that in your case the muscles proper have become flabby.
Proper guided exercises would help.

On a higher note:
High resolution Ultrasonography with color doppler and electromyography would confirm the intact nerve and vessel supple (if needed) and if intact then the proper exercises should help to recover well. Please go for gradually increasing exercises as there is a mid line scar.

I hope this answer helps you further.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. T Chandrakant (5 minutes later)
Thank you very much. I'm glad it's not a hernia. Will work on strengthening the muscles.

Appreciate your answer.
doctor
Answered by Dr. T Chandrakant (6 minutes later)
Brief Answer:
Thanks for your appreciation.

Detailed Answer:
You are most welcome.
You may please rate the answer before closing.

Take care.
All the best.

You may contact me in future for any query.
Dr T Chandrakant.
General Surgeon.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Dr. T Chandrakant

General Surgeon

Practicing since :1984

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Hi i had surgery 8 months ago to remove a

Brief Answer: Please give details and post actual photographs as requested for. Detailed Answer: Hi. Thanks for your query. Noted the history well, seen the 2 photos in lateral views and understood the concerns. Please provide additional information for me to assist you better: Your age and gender please. Please post front view photos, also showing the incision taken for surgery. Did the bulge appear soon after surgery, say noted after you started moving around or late? Does the bulge increases on coughing or straining? How does it looks like on laying flat in bed and trying to lift head and legs simultaneously on bed. Please post all such photos. Does the bulge increase or reduce on trying to retract the abdominal wall like straining? Any symptoms like pain? Any other information please. Awaiting for your feedback and all photos.