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Suggest treatment for symptoms of hernia

Answered by
Dr.
Dr. T Chandrakant

General Surgeon

Practicing since :1984

Answered : 17883 Questions

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Posted on Wed, 25 Jan 2017 in Lump
Question: I believe I have a hernia in a rare spot and the ER didn't find anything. The bulge is down before I go to the hospital. When it pops out it knocks me down and I have to lay still until the bulge goes back down. This just started a month ago. It has popped out 4 times. This last time was the worse causing me to pass out twiice and I am in a lot of pain. I found something to bind my abdomen. Is binding it okay? This is happening on my right side just under my ribs and I don't think it is a normal spot, I'm not a doctor but I know what is happening in my body.
doctor
Answered by Dr. T Chandrakant 2 hours later
Brief Answer:
Get referred to a General Surgeon

Detailed Answer:
Hi.
Thanks for your query, short and specific.
Read your history and understood the concerns.
Anything that pop put if the abdominal cavity to come under the skin and goes back is the most classical symptoms and signs of a hernia.
Since you know there is something bulging with lots of pain and is reducible, this is hernia.
The pain indicates that there is obstruction on the neck of the sac with its contents and hence the pain. It also indicates that the neck is very narrow hence difficult to find the opening in many a cases.
Proper clinical examination by a General Surgeon along with high resolution ultrasonography of the abdominal wall and/or CT scan can get you the correct diagnosis; and if present, you should get this operated asap.

I hope, this answer helps you.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. T Chandrakant 1 hour later
when is a hernia an emergency? I won't go back to the hospital because last night after passing out and being in severe pain I heard the nurse tell the doctor I was just there for drugs. I was given a 5mg percoset, an x-ray and sent home without the doc addressing the hernia.I just need to know when it is an emergency. I started vomiting tonight and now can't keep anything down. I am running a low grade fever as well. My abdomen is burning and very painful. Will I be okay until I see my doc tomorrow?
doctor
Answered by Dr. T Chandrakant 2 hours later
Brief Answer:
As discussed in details below.

Detailed Answer:
Read the feedback given by you.
Nurse does not decide what is right or wrong. If the Nurse or a Doctor- preferably a General Surgeon does a proper clinical check-up, investigations the correct diagnosis may be done.
What was the X-ray report?
Bloating/distention, vomiting, pain and sometimes inability to pass gases and stool is indication that it is an emergency hernia problem.
Sometimes there is partial intestinal obstruction when the hernia is small and still can cause symptoms to raise the suspicion.
How can I tell whether you will be okay until see your Doctor tomorrow. IF the symptoms are persistent, you should visit ER.


Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. T Chandrakant 40 hours later
I saw my doctor yesterday and he thinks it is a trigger point. He wants me to take a picture the next time it happens. I am still in pain and am worried that it is a hernia in an unusual place making it harder to diagnose. I just don't know what to do. I have my abdomen bound. I don't want it to happen again. Is it okay to have it bound? How can I convince my doctor to believe me that it is a hernia? He did not order any tests.

I have been having slight pain lower than where it pops through. I have been putting a strap around my abdomen but the lower pain worsens when I use it. Is it possible that nothing would show on a CT scan or x-ray? Any idea why it would hurt in one spot lower than where I suspect the hernia?
doctor
Answered by Dr. T Chandrakant 2 hours later
Brief Answer:
As detailed.

Detailed Answer:
Please give some information:
How much is the fat on abdominal wall where the problem is?
- if it is least then it is easy to palpate and also seen the movement of popping in standing and laying down relaxed position.
- If the fat pad is too much then this clinical test is difficult to find and hence the necessity of investigations.
Have you been examined by a General Surgeon?

It seems your Doctor has palpated and felt this to be a trigger point as it must have appeared like a knot.
It is okay to have bound provided it is done after the hernia, if present is in fully reduced position.
You really do not have to convince as the clinical tests of palpating while coughing hard, and reducibility are the classical signs of hernia.
Pain lower than popping can be muscular or nerve stretching.
X-ray helps if there as associated intestinal obstruction.
Real time high resolution Ultrasound of the abdominal wall is the best investigation.
CT scan of the whole abdomen and particularly for the hernia in the wall may show up hernia. Rare is the possibility that it may not show up.

When you photograph the area after popping or so attack one copy with this question too.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. T Chandrakant 2 hours later
I weigh 133 pounds. I have not been referred to a surgeon. My doctor examined me but I did not make it pop out. I will go back next week when the pain has subsided and make it pop out for him so he will see it is not a trigger point. I do not look forward to that because it incompasitates me and I can't move for a while until it goes back in. Each time it happens it hurts worse and for longer periods. I will gladly send a photo when it happens again. Thank you for the feedback. It helps ease my worry a bit.

I have had Rare things happen in my body. So a hernia in a rare place not showing up on a CT scan doesn't XXXXXXX me if that is the case. After my second thorasic surgery the doctor came in and asked me if I had any japenese blood in me, I asked why and he found a rare tumor in my spine found only in japenese men between the ages of 15 and 22 in their knees. He said I was one for the medical books. I have a weird medical history as well.
doctor
Answered by Dr. T Chandrakant 7 hours later
Brief Answer:
Should be clinical evaluated and examined, better not to wait ...

Detailed Answer:
It happens - some people/patients have similar histories of having rare things and in fact this may indicate that your hernia if present should be diagnosed and operated asap, not after having some complications.
You can certainly insist for the investigations as I have suggested.
The goal is to get the correct diagnosis asap.
Hope to see you diagnosed and treated asap.
If you have pain, you need examination and investigations now.
If possible go for a second opinion, preferably of a General Surgeon.
All the best.
Awaiting for your feedback
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. T Chandrakant 17 minutes later
Thank you for the feedback. I am going to get a third opinion. I am going to see if I can see the surgeon without a refferral. I hope I can see him. I do not want to wait much longer and don't want it popping out again. I am afraid that if it happens again that it won't reduce. I just don't understand why my doc isn't convinced. I only need to make it pop for the surgeon.
doctor
Answered by Dr. T Chandrakant 5 minutes later
Brief Answer:
Another opinion

Detailed Answer:
If the Doctor is not convinced, we can not really help hence the need for another opinion and that too of a General Surgeon or the ones that are known in the field of hernia.
High resolution ultrasound of the abdominal wall should help you further.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. T Chandrakant 6 hours later
I will be calling the surgeon we have here tomorrow I wish we had more than one. I really hope I can see him without a referral. If not I will just have to ask my doc for one. At least I am only 80 miles from better and more doctors to choose from. If I don't feel the surgeon here can handle rare hernias I will ask him to send me elsewhere. What questions do I need to ask to determine his ability? Our hospital has made friends of mine very sick. They sent my cousin home to die. She was 34 with no severe health issues. It is not the cleanest or a very good hospital. How long can I wait? I hope I can see the surgeon this week. I just want a very competent and confident in his abilities doctor. I don't have any confidence in our hospital or its staff. Are rare hernias harder to repair? Could it be part of my liver popping through and not intestine?
doctor
Answered by Dr. T Chandrakant 9 hours later
Brief Answer:
As discussed in details below.

Detailed Answer:
Thanks for your feedback.
Hope that you have consulted the Surgeon.
There is no question to be asked - it is the detailed history that you have to tell the Surgeon which will help for diagnosis.
The principles of repair of the hernia are same irrespective of the site and type of hernia hence nothing special needs to be worried about.
Liver can not pop through the hernia.

Please give feedback .
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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