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Suspect A Hernia In Lower Left Groin Or Abdomen Area. Got CT Scan Done. What Are The Findings?

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Posted on Mon, 3 Jun 2013
Question: Is it possible to upload CT Scan images here, I have the cd? If so, please let me know which folders to upload. I suspect a hernia in my lower left groin/abdomin area.

I have been having the same symptoms since December 2012, even after the CT Scan (bulges/lumps). I want a second opinion and perhaps another type of scan.

Also, is it better to get a MRI to detect small hernia. I have a small atheletic build - very muscular.

Thank you.
doctor
Answered by Dr. Ganesh Sanap (1 hour later)
Hi, welcome and thanks for writing in.
You can upload images rather than complete CD. Please upload axial and sangital images of groin areas. They might be marked on CT scan film. You can take snap of the same and upload it. There is column of attachments on your dashboard. You can upload over there. If you have any problem in uploading images please contact customer care support@ health care magic.
No need of MRI for such hernias. Dynamic ultrasonography is simple and most reliable test in such hernias.
We will discuss investigations after reviewing ct images.

Looking forward for your response.
Regards.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Ganesh Sanap (2 days later)
Dr. Sanap,

I am still have trouble uploading the images even after calling customer care. I will do my best to get it resolved.

Any other suggestions?

Thank you, XXXXXXX
doctor
Answered by Dr. Ganesh Sanap (35 hours later)
Hi, welcome back.
First of all extremely sorry delay as it was quite difficult to get upto images.

I have gone through CT scan images. There is mild collection in scrotum in bilateral tunica vaginalis. It covering of testis.
There is no obvious herniation of bowel loops or any intraabdominal structure in scrotum noted. So it doesn't look like a hernia on Ct scan images.
Rest of the structure are grossly normal. There is no role of MRI in these condition, So dont waste money for that.
Sometime hernias are transient which occurs on standing or incresed intraabdominal pressure. I will suggest just go for ultrasonography of inguinal and scrotal region. It can be done during increased abdominal pressure. Also nature of fluid collected can be better appreciated. It is also cheap and easily reproducible investigation.

Hope i have answered your query. If you have further concern please let me know.

Regards.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Ganesh Sanap (9 hours later)
Thank you Dr. Sanap for the response.

A couple of questions:

1) You stated "There is mild collection in scrotum in bilateral tunica vaginalis. It covering of testis."

- What exactly does this mean? What causes this, is it something to be concerned about, is there a way to reverse this? Will it affect the ability to have children?

2) You stated "Also nature of fluid collected can be better appreciated. It is also cheap and easily reproducible investigation."

- Are you saying that there could just be fluid build up? If so, when you stated 'It is also cheap and easily reproducible investigation' does this mean there is something I can take to reduce fluid build-up? If so, what can I take.

3) Are you able to evaluate ultrasound images as well. I can upload if so - please let me know.

4) On a separate note, can you take a look at my kidneys and tell me if there is something there in either one?

Thank you for your time as I am sure that you are very busy.

Sincerely, XXXXXXX
doctor
Answered by Dr. Ganesh Sanap (7 hours later)
Hi, welcome back.
Fluid collection is usually reactionary. It is difficult to state the cause for it. Sometimes Intra abdominal fluid which is normal may trickle in scrotum through spermatid cord. Fluid is usually get resolved on treatment. No need to worry about that.
Ultrasonography is cheap and easily reproducible means it cost less amount as compared to MRI and also in follow up it can be easily done and compared .
I have already seen kidney there are small simple cysts on right kidney. I just didn't mention to avoid anxiety as it it completely harmless.
You can upload ultrasonography images also . I will able to get on that also.
You need to consult your surgeon for further management and treatment.

Hope I have answered your query.

Regards.


Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Ganesh Sanap (8 days later)
Dr. Sanap,

thank you for working with me and answering my questions thus far. You have been very helpful.

I have an Ultrasound on CD using iSite Viewer. They kind of look like little short videos, about 20 of them. Do I just upload the DICOM files?

Thank you.
doctor
Answered by Dr. Ganesh Sanap (3 hours later)
Hi, welcome back.
If possible please try to upload JPEG format images or AVI format videos. It is easy to view on any computer without any software. If not possible you can upload whatever you have. Be sure that you have uploaded images with viewing software.
Hope this will work and helpful for you.

Regards.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Ganesh Sanap (11 hours later)
Dr. Sanap,

I sent an email to have the Ultrasound files uploaded for your review. I was not able to upload the iSite Media Player or AVI file. Please let me know if I need to do anything else on my end.

Thank you, XXXXXXX
doctor
Answered by Dr. Ganesh Sanap (25 hours later)
Hi, welcome back.
I reviewed your ultrasonography images. I want to know few more things as there are no videos.
1. Ultrasonography is done in inguinal region or testes region?
2. Have they mentioned herniation 9f bowel loops on valsalva maneuver.?

Looking forward for your response.

Regards.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Ganesh Sanap (1 hour later)
Hi, thank you for the response.

Yes, the Ultrasound was primarily done in ingunal area but the doc briefly checked my testes also.

Now that I think about it, there were no videos only a bunch of images which made it seem like videos to me. Sorry.

No, there was no mention of a hernia 9f...is this something I need to get repaired. I can tell somethings not right and its been going on since December 2012.

Does it look like a big hernia? Shoul I have another CT Scan or MRI?
Also, what type of pain is associated with this kind of hernia? Should I feel a lot of pain, would I be able to perform extensive excercises?

Thank you.

Thank you.
doctor
Answered by Dr. Ganesh Sanap (19 hours later)
Hi, welcome back.
I have gone through your ultrasonography images. It looks there is no herniation of any bowel loops. It means there is no hernia. There are images taken after valsalva maneuver , which doesn't show any hernia.
At present there is no need of any further investigation or repeat CT scan. Findings are similar to CT scan images. As there is no hernia , no need to repair anything. You can perform your exercises normally. Just be sure you put waist band while lifting heavy weight. There is no cause found on imaging for pain. It must be related to any other cause which is not detectable on imaging.

Hope I have answered your query.
Regards.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Ganesh Sanap (27 hours later)
Thank you Dr. Sanap, you have been of great assistance to me thus far and I really appreciate your patience.

I am sorry I misunderstood when you said:
"Have they mentioned herniation 9f bowel loops on valsalva maneuver.?"

I thought you may have seen a herniation but was confirming with me on whether or not the doctors mentioned it to me.

At this point I am not sure what is going on. The doctor did mentioned that I don't have a lot of fatty tissue in that area which is why I may be able to feel my bowel. But the thing is I have been this size and even smaller before.

Maybe I damaged some nerves or something in that region and it is taking a while to heal properly.

There is one more thing I would like to do prior to closing my discussion with you. I had an Ultrasound completed prior to the one you recently evaluated and it was prior to the current injury that I have.

Is it possible to take a look and it and compare the two for any significant changes. Is there loss of muscle mass, possible muscle tear or strain that may be still healing. Anything else that looks different.

I already uploaded the files through the attachment email address as usual.

My doctor wants me to have another colonoscopy but I would like to rule out everything else before having another one.

Should I consult with a Neurologist. I do have tingling sensations and vibrations that go on in that area as well.

Thank you for you for everything -- this process is giving me piece of mind.
doctor
Answered by Dr. Ganesh Sanap (34 hours later)
Hi, welcome back.
I have gone through your ultrasonography images. There is no obvious pathological finding in that images. Even on valsalva maneuver there doesn't look herniation of any bowel or else. So it is less likely you are having hernia.
As your complaints are quite chronic , you need multi specialist approach. Colonoscopy is one of the investigation which finds hidden pathologies. I think you are opt for that. It is comes normal then only have a consultation with neurologist. It is also quite difficult to comment on nerve damage as there are no sign of it.

Hope I have answered your query.

Regards.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Ganesh Sanap (37 hours later)
Thank you so much Dr. Sanap for all of your help and support thus far. You were very patient with me and I appreciate that.

I will be sure to provide a review via this site.

If I have any further questions or concern withing your expertise, I will be sure to contact you.

Best Regards, XXXXXXX
doctor
Answered by Dr. Ganesh Sanap (25 hours later)
Hi. XXXXXXX
Thanks for your appreciation. Hope our information is helpful for you. Feel free to ask further queries.

Regards.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Dr. Ganesh Sanap

Radiologist

Practicing since :2007

Answered : 561 Questions

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Suspect A Hernia In Lower Left Groin Or Abdomen Area. Got CT Scan Done. What Are The Findings?

Hi, welcome and thanks for writing in.
You can upload images rather than complete CD. Please upload axial and sangital images of groin areas. They might be marked on CT scan film. You can take snap of the same and upload it. There is column of attachments on your dashboard. You can upload over there. If you have any problem in uploading images please contact customer care support@ health care magic.
No need of MRI for such hernias. Dynamic ultrasonography is simple and most reliable test in such hernias.
We will discuss investigations after reviewing ct images.

Looking forward for your response.
Regards.