OpenHealth Q&A

Request for Insight on Possible Hernia Symptoms and Imaging

**Subject:** Insights Needed on Potential Hernia Assessment Hello everyone, I am a 38-year-old woman with no prior surgical history seeking insights from medical professionals regarding persistent symptoms suggesting a possible hernia or similar issue. **Summary:** My symptoms, which are more pronounced on the left but still present on both sides of the lateral abdomen from the ribs to the pelvis, indicate a possible hernia. I am struggling to obtain a second professional opinion despite earlier imaging reports citing 'normal' results. I have had a recent CT scan and a slightly older MRI, both of which I would like to discuss. Unfortunately, my primary care physician requires a solid rationale to request a follow-up imaging review, especially since I’ve encountered unreliable imaging assessments before. As someone who has taken the initiative to research and understand my medical situation, I believe there may be underreported findings in my recent CT scan that have not been acknowledged in past assessments. Having learned about medical imaging and analysis, I can identify that there might be concerning alterations in my latest CT scan that suggest anomalies related to my transversus abdominis (TA) muscle, particularly noticeable on the left side but present bilaterally from my pelvis upward toward my ribs. The onset of my symptoms coincided with attempts to practice diaphragmatic breathing, during which I first detected a lump in my left lateral abdomen that was reducible and accompanied by audible gurgling. Whenever this lump feels 'stuck', I experience a sharp ripping sensation, often related to relieving constipation and subsequent pain, but over time this has led to a general decline in my symptom status, including difficulties in normal breathing. Upon reviewing the images, the muscle structure in this region appears abnormal to me—though I am not qualified to make any medical determinations. In reviewing the imaging, I have delineated what I think might be the TA, noting that it has an HU value of 50, which seems consistent with muscle tissue. This observation raises my concerns about a potential structural defect or abnormal protrusion that might be linked to my ongoing symptoms. I want to clarify that my insights are derived from self-education and not from an intent to assert a diagnosis. Additionally, I’ve had an ultrasound confirming bilateral groin hernias; however, the specific locations of these hernias remain unclear. Recently, I have also noticed intensified pain in my left buttock, resembling the symptoms associated with my other hernias. While my first CT scan appeared normal, my symptoms have exacerbated over time, and my latest imaging shows notably different appearances in the area of concern compared to previous scans. Given the ultrasound verification of bilateral groin hernias, I am eager to explore any related or overlooked structural concerns that could be contributing to my health issues. **Medical Background Summary:** - **Ehlers-Danlos Syndrome (hEDS)** – Diagnosed in 2022 - **Slipping Rib Syndrome (bilateral)** – Diagnosed in 2023 - **Sciatica** – Resolved through exercise in 2023 but has recently recurred on the left side - **Notable weight loss** – 70 lbs drop from 2022 to 2023 - **Chronic core muscle dysfunction** – Feeling of constriction during muscle contraction - **Worsening chronic constipation** – Now non-responsive to laxatives since 2023 - **Episodes of severe tearing pain** extending from the groin to the subcostal area, followed by temporary relief - **Shortness of breath & postural difficulties** – Sensation of weight pressing down my rib cage - **Intermittent soft, movable lumps in the abdomen** **Imaging History:** - CT KUB (July 2023) - Dynamic Abdominal Ultrasound (Aug 2023) – A radiologist referred me to urology for follow-up - Several abdominal CTs, including one in May 2024, that noted a small umbilical hernia and related issues - Confirmed bilateral groin hernias through ultrasound, exact locations indeterminate - MRI Abdo/Pelvis December 2024 – Reported normal but shows potential discrepancies compared to CT results - February 2025 CT (ordered in the emergency department due to worsening symptoms and new left buttock pain similar to hernia discomfort) If anyone can identify anything in the scans that may need further examination, I would truly appreciate your insights. Thank you!

Answers (1)

3/18/2025, 1:40:56 AM

OpenHealth AI

You’re facing a complex situation with concerning symptoms that may suggest hernias or related issues, especially given your background of Ehlers-Danlos Syndrome and other abdominal challenges. I understand you are seeking clarity on your imaging results and how they relate to your ongoing discomfort. Let’s break this down into key components.

Main Points

1. Chronic Symptoms: Your persistent abdominal discomfort and history need thorough evaluation.
2. Imaging Concerns: Your insights on the imaging, particularly regarding potential abnormalities, are valid.
3. Actionable Next Steps: We can outline some steps to help you address these health concerns effectively.

Explanation

Your symptoms, including the presence of lumps, sharp pain, and difficulties with breathing, coupled with your diagnoses, indicate a situation where underlying structural issues may be exacerbated by your connective tissue disorder. Ehlers-Danlos Syndrome often leads to weakened tissues, which can complicate conditions like hernias, and these might not always be clearly visible on imaging.

You’ve already noted that the ultrasound confirmed bilateral groin hernias, which is significant. Your experience of being able to identify potential abnormal characteristics on imaging is commendable, but it’s crucial to have these assessed by a qualified healthcare professional who can correlate clinical findings with imaging results.

Next Steps

1. Symptom Diary: Keep a detailed diary of your symptoms, including when you notice the lumps, the intensity and nature of the pain, and any associated symptoms (like breathing difficulties). This can help you and your healthcare provider identify patterns and triggers.

2. Request Imaging Reevaluation: Consider compiling your observations about the imaging findings and how they correlate with your symptoms. Present this information to your primary care physician or surgeon to make a compelling case for a review. Mention your history of imaging inconsistencies as a reason for needing further evaluation.

3. Referral to a Specialist: Seek a referral to a specialist, such as a gastroenterologist or a surgeon with experience in hernia evaluation and treatment in patients with Ehlers-Danlos Syndrome. They might have access to specific imaging techniques or expertise in recognizing subtle abnormalities.

4. Physical Therapy: Given the chronic nature of your core muscle issues, a personalized physical therapy program may assist in managing your symptoms better, especially focusing on strengthening and stabilization that accounts for your herniation and connective tissue condition.

5. Management of Constipation: Since you've reported worsening chronic constipation, consider discussing dietary adjustments (such as increased fiber intake) and hydration strategies, alongside any available medical management or digestive health strategies.

6. Follow-Up on Pain: For immediate pain and discomfort, consider utilizing heat therapy or over-the-counter anti-inflammatory medications (if appropriate) for symptomatic relief and monitor any significant changes in your symptoms.

It’s essential to approach your care as a team involving you, your primary care provider, and specialists. Your insights are valuable, and persistence in seeking answers is crucial. Keep advocating for yourself, and don’t hesitate to reach out for further support or clarification.