Suggest Treatment For Pain Above The Incision After Epigastric Hernia Repair Surgery

Posted on Thu, 18 Jun 2015

Medically reviewed by Ask A Doctor - 24x7 Medical Review Team

Thu, 18 Jun 2015 Answered on

Tue, 14 Jul 2015 Last reviewed on

Question : I had an epigastric incisional hernia repair in january as some omentum was incarcerated in the hernia. I was given an antibiotic I was allergic to, had an anaphylactic reaction post-op and major bloating issue.a a few weeks later I had to be admitted to a different hospital in acute kidney failure, small bowel obstruction and with C.diff. I've had 2 more hospitalizations to get rid of the C.diff and still am experiencing bloating. I was perfectly healthy before the surgery. Now I have pain above the incision and it feels as though a new small hernia has developed which was seen on CT. I just had an abdominal untrasound, all organs normal except the comment was:At the superior aspect of the prior midline incision approximately
1.2 cm deep from the skin there is a region of echogenicity and
shadowing which appears nonspecific, but may represent surgical
suture material versus fat necrosis, among other etiologies. This
correlates with soft tissue stranding on prior CT examination.

Impression
IMPRESSION:

1. No cholelithiasis or cholecystitis. No intra-or extrahepatic
biliary dilatation. Normal appearing liver parenchyma.
2. At the superior aspect of prior surgery there is an ill-defined
region of hypoechogenicity which likely represents postsurgical
change. Please correlate clinically.
What the heck is soft tissue stranding? Did I just get a bad ultrasound?

Answered by Dr. Grzegorz Stanko (-4 hours later)

Brief Answer:
It can be stitched omentum.

Detailed Answer:
Hello!

Thank you for the query.

The ultrasound you have done is not wrong or bad. There is a region in the scar where the ultrasound can not unambiguously determine what exactly is seen.
But this finding clearly tells that the strange region can be the source of the pain. It can be a suture giving you some reaction. It is also very probable that this suture holds omentum. In other words, during the hernia repair, omentum could get cough with one suture. If it happens, usually gives pain. We can call it small hernia indeed. And this is what they call soft tissues stranding.

I suggest you to consult general surgeon with this problem. Physical examination should be performed at first. Small incision and tissues verification seems necessary.

Hope this will help. Feel free to ask further questions.
Regards.

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