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What causes intermittent pain around the surgical incision of abdominal surgery?

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Posted on Sat, 21 May 2016
Question: several years ago I had abdominal surgery toremove a lipoma from my small bowel. since then, I had intermittent pain-sensitivity around the surgical incision which i self-treated with over the counter topical anaesthitics. Now, the pain has gotten worse and is spreading to more areas on my abdomen.The pain medicine is not very effective now. My primarycare MD doesn't know why, and has referred me to a plastiic surgeon who I have not seen yet. The operating surgeon had thought it was phantom pain. No blisters or sores on belly. No fever. I had the shingles vacine. What could this be. Lastly, for several years now, I have been followed by other doctors for side branch IPMN.
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Answered by Dr. T Chandrakant (26 hours later)
Brief Answer:
Nerve entrapement

Detailed Answer:
Hi.
Thanks for your query.
To recapitulate: Male/82 - lipoma from small bowel removed several years ago - intermittent pain - *sensitivity around surgical incision - self treated with OTC anesthetic - now gotten worse and spreading to more area on abdomen - Primary care MD does not why - referred to Plastic Surgeon - Operating Surgeon feel this to be phantom pain - no blisters, sore, fever - shingles vaccine - followed by other Doctors for side branch IPMN - Want to know the reasons...

From the elucidate description the possibilities are:
- Nerve entrapment at the incision in the abdominal wall with formation of sort of granuloma that becomes more sensitive with or even without stimulation.
This can be simply tested by giving local/intra-lesional anesthetic and if the pain is abolished, proves the diagnosis. Multiple sessions can pin-point the area and can then be explored, excision of the offending part done and may get permanent relief.
Nerve sedatives oral tablets can also be tried, needs a prescription.
- Another remote possibility is of a small incisional hernia that is pressing on nerve/s and causing the symptoms. This can be found on the local examination by a Doctor and high resolution ultrasound examination of the abdominal wall con confirm whether there is hernia or not. Might have been found by this time in your case.

I hope this answer helps you, please feel free to ask for further relevant queries if you feel there is a gap of communication.
I was just wondering about - Lastly, for several years now, I have been followed by other doctors for side branch IPMN. Please elucidate.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
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Dr. T Chandrakant

General Surgeon

Practicing since :1984

Answered : 19417 Questions

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What causes intermittent pain around the surgical incision of abdominal surgery?

Brief Answer: Nerve entrapement Detailed Answer: Hi. Thanks for your query. To recapitulate: Male/82 - lipoma from small bowel removed several years ago - intermittent pain - *sensitivity around surgical incision - self treated with OTC anesthetic - now gotten worse and spreading to more area on abdomen - Primary care MD does not why - referred to Plastic Surgeon - Operating Surgeon feel this to be phantom pain - no blisters, sore, fever - shingles vaccine - followed by other Doctors for side branch IPMN - Want to know the reasons... From the elucidate description the possibilities are: - Nerve entrapment at the incision in the abdominal wall with formation of sort of granuloma that becomes more sensitive with or even without stimulation. This can be simply tested by giving local/intra-lesional anesthetic and if the pain is abolished, proves the diagnosis. Multiple sessions can pin-point the area and can then be explored, excision of the offending part done and may get permanent relief. Nerve sedatives oral tablets can also be tried, needs a prescription. - Another remote possibility is of a small incisional hernia that is pressing on nerve/s and causing the symptoms. This can be found on the local examination by a Doctor and high resolution ultrasound examination of the abdominal wall con confirm whether there is hernia or not. Might have been found by this time in your case. I hope this answer helps you, please feel free to ask for further relevant queries if you feel there is a gap of communication. I was just wondering about - Lastly, for several years now, I have been followed by other doctors for side branch IPMN. Please elucidate.