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Q. I have a bulge in my left lower abdomen above a scar from surgery last year. What is it?

Answered by
Dr. Naveed Ahmed Khan
and medically reviewed by Dr. Sneha Kannan
This is a premium question & answer published on Jul 03, 2020

I've got a bulge in my left lower abdomen above a scar from surgery last year. It first appeared late last year and the CT showed I was constipated so my Drs left it at that. In the last couple months, I've been working with GI since it's gotten bigger and more painful. I did another CT but the results are not back. I did a complete colon cleansing before the CT so it would be clear; I've done this before with no issues. Pain from the bump woke me up this morning and for the 2nd time, it's had me in tears. My Dr wants me to wait t do a XR tracking test next week since there is no discoloring, fever, vomit, or diarrhea. I'm alternating ice & heat and have a 5lb weight blanket on it. Nothing is helping. I am a chronic pain patient so am hesitant to go to ER in fear of being written off even though this is not related to my other conditions. When should I consider and/or just go to ER?

Dr. Naveed Ahmed Khan

General Surgery
#

Hello,

I understand your concern that you are having a bulge in the left lower abdomen near the scar . You have done a CT scan and it has been in conclusive.

It would be good to know if the bulge is decreasing when you lie down or increasing when you get up from your bed .

If the bulge is increasing on coughing or getting up from bed I can guess you might have had either a ventral hernia which might have been reducible and now it’s not reducible that is probably the cause of your pain . If this is the case you need to check your self into an ER get an Ultrasound down to rule out any obstruction.

If this is the bulge decreases while getting up from the bed there are various possibilities ranging from colonic mass to turbo ovarian mass . Which need further assessment By a contrast enhanced CT abdomen . and if a colonic mass is proven then you further need a Colonoscopy. To arrive at the diagnosis.

For now i suggest you to head to the nearest ER for a routine investigation and further assessment .


The Probable causes:

Incisional Hernia , colonic mass , tubings ovarian mass

Investigations to be done:

Ultrasound abdomen, Contrast enhanced CT Abdomen ,

Treatment plan:

Head to ER for further clinical assessment and investigation

Regarding follow up:

Follow up with Contrast Enhances CT abdomen


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