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49 yr. old female. Had severe pain in Sept. in lower right side. Went to hospital, took cat scan no appendicitus. Since then, have a protrusion on lower right adbdominal side, hurts when I sit, and I have pains that come and go every hour all day. Had sonograms. Showed a few fibroids, cyst, no hernia. Is a laparascopy the next best step to be able to go inside and see what is causing the problem?

Submitted: 659 days ago.
Category: Health
Value: $15
Status: 
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Optional Information

Optional Information:
Female, Age: 49, Pennsylvania

Already Tried:
Sonograms-pelvic and abdominal. Could hysterectomy be in order? But don't understand the protrusion on the side. Always there.

Accepted Answer

Your protrusion and pain could be due to several things. Here's a link to abdominal masses in general: http://www.nlm.nih.gov/medlineplus/ency/article/003274.htm

It sounds like you have a right lower quadrant external bowel herniation. http://www.nlm.nih.gov/medlineplus/ency/imagepages/1090.htm An external bowel herniation wouldn't show up on a scan because during the scan you're lying down and the scan is a static picture not a dynamic one. Most hernias produce no symptoms. They are noticed as a protrusion (lump) which goes away when you lay down. The concern with hernias is incarceration. A hernia can be examined and treated using a laparascope. It's too soon to know if you will need a hysterectomy. First, you need a surgeon to use a laparascope to see what the protrusion is caused by.

If you have a question please ask me.

Dr. Hanson

Expert: Dr. Hanson
Pos. Feedback: 99.0 %
Accepts: 
Answered: 2/1/2008

Doctor (MD)

Diplomate, American Board of Quality Assurance & Utilization Review Physicians

658 days and 23 hours ago.

Reply

Your suggestion that it might be a bowel herniation-is it still possible even though I have no problems with my bowels. Everything is going in and coming out alright. No pains with movements. Formed stools. Since it has been so long to get a diagnosis on this. Am I causing further damage by waiting so long before treatment to correct this? Any more info would be helpful. Thank you.

Posted by Dr. Hanson 658 days and 22 hours ago.

Answer

Hello. Yes, you can still have an "external" bowel herniation even without any bowel problems. In fact, most people with external bowel herniations are asymptomatic (don't have any symptoms) except that they can feel or see a lump over their intestine. The problem is that there is no telling when or if the herniated bowel will become "incarcerated" (squeezed and the circulation to the bowel becomes cut-off).

Here's a link to an article where a gentleman had a similar case to yours: http://www.liebertonline.com/doi/abs/10.1089/109264204322973907

A surgeon should perform exploratory laparascopic surgery to find out specifically what is causing your painful lump.



Edited by Dr. Hanson on 2/1/2008 at 5:52 PM

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