Seeking Insight on Missed Ventral Richter Hernia Diagnosis
Hello everyone, I’m a 34-year-old female, measuring 167 cm and weighing 80 kg, with a history of a ventral Richter hernia that has persisted for over 15 months. I do not smoke. Today marks my appointment with a general surgeon, and while I’m not seeking medical advice, I’m eager to gain a better understanding of my circumstances. I would greatly appreciate perspectives from those in radiology or imaging technology. For the past year, I have been seriously unwell, only to recently discover that I might have had a hernia all along, which unfortunately went unnoticed in several CT scans. To provide some background: I underwent laparoscopic surgery alongside adhesiolysis for endometriosis in March 2024. The day following my surgery, the surgeon informed my partner and me that he had uncoiled a segment of my bowel that was twisted against my abdominal wall, although this information was absent from the official surgical report. Shortly after my procedure, about two weeks later, I began to experience severe health issues that altered my daily life. My symptoms included intense abdominal discomfort, relentless nausea and vomiting, extreme fatigue, incapacitating night sweats with a disturbing odor, and a series of persistent illnesses. Within a mere three months, I lost approximately 50 kg. I repeatedly expressed to my medical team that I felt “toxic” and that something was severely wrong inside me, yet I was often dismissed, being told it was likely just anxiety or irritable bowel syndrome. Over the past year and three months, I underwent around seven CT scans and multiple MRIs, all of which yielded normal results. However, two weeks ago, an abdominal ultrasound revealed the presence of a Richter hernia, and the radiologist noted that it had been visible on the previous CT scans. This leaves me puzzled about how it could have been overlooked until now. Additionally, I’m concerned about the cumulative radiation exposure I’ve endured during this time. A subsequent review of the earlier CT images identified a ventral/incisional hernia, some bulging of the abdominal wall, signs of mesenteric fat stranding (potentially due to adhesions), and free fluid—all of which had previously gone unreported. For context, I also deal with IgA deficiency, putting me in an immunocompromised state, and I carry the heterozygous Prothrombin G20210A mutation, which could put me at greater risk for blood clots. Have any of you experienced or heard of cases where hernias, particularly ventral or incisional types, were initially missed in CT scans over extended periods? Thank you for taking the time to read this. I genuinely value any insights you can share with me.
Answers (1)
7/15/2025, 12:50:59 AM
OpenHealth AI
Thank you for sharing your experience and concerns regarding your recent diagnosis of a ventral Richter hernia. I can understand how frustrating and distressing it must be to have gone through numerous imaging studies without getting the answers you needed. Here's a concise overview of your situation, an explanation, and some practical steps you can take.
Main Points
- Your recent diagnosis of a ventral Richter hernia, previously missed in multiple CT scans, raises valid concerns about diagnostic accuracy.
- Cumulative radiation exposure from numerous imaging studies is a valid concern, especially given your history and immunocompromised state.
Understanding the Situation
Hernias can sometimes be difficult to visualize on imaging, especially in early stages or if the imaging technique is not optimized. CT scans can miss small or subtle findings, particularly if the hernia is not causing significant symptoms at the time of the scan. The discovery of a hernia through an ultrasound — a method often more sensitive for certain types of abdominal issues — may underscore the importance of considering different imaging modalities.
The fact that your symptoms persisted for over a year and included significant weight loss and discomfort indicates a serious underlying issue that may involve complex interactions of your surgical history, potential adhesions, and your immunocompromised state. It’s understandable that you feel concerned about being dismissed in the past, especially with serious symptoms.
Next Steps
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Clarify Surgical and Imaging Findings: During your appointment with the general surgeon, it’s crucial to discuss how the hernia may be impacting your health and any recommendations for surgical intervention. Ask specifically about how this hernia was missed previously and what imaging techniques may be more effective for future assessments.
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Manage Symptoms: Continue to monitor your symptoms closely. If you experience new or worsening issues, such as increased abdominal pain, changes in bowel habits, or persistent nausea, keep your healthcare team informed.
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Radiation Exposure Concerns: Discuss your cumulative radiation exposure with your healthcare provider. They can help ensure that future imaging is necessary and consider alternative methods if needed, such as ultrasound or MRI, which do not use ionizing radiation.
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Address Immunocompromised State: Given your IgA deficiency and the potential risks associated with your Prothrombin mutation, it may be worth reviewing this with a specialist in immunology or hematology to ensure you have adequate monitoring and support for your unique health situation.
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Seek Support: Connecting with others who have had similar experiences might provide you with additional support and insights. Consider joining a support group focused on hernia or chronic illness management.
I sincerely hope your appointment goes well, and you get the clarity and care you deserve. If you have more questions or need further clarification after your appointment, feel free to ask.
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