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 and last reviewed on: Apr 26, 2021

Hi doctor,

I had 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 doctors left it at that. In the last couple of months, I have been working with GI since it is 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 have done this before with no issues. Pain from the bump woke me up this morning, and for the second time, it had me in tears. My doctor wants me to wait to do an XR tracking test next week since there is no discoloring, fever, vomit, or diarrhea. I am alternating ice and heat and have a 5 lb weight blanket on it. Nothing is helping. I am a chronic pain patient, so I am hesitant to go to ER to fear being written off even though this is not related to my other conditions. When should I consider or just go to ER?

#

Hello,

Welcome to icliniq.com.

I understand your concern that you have a bulge in the left lower abdomen near the scar. You have done a CT scan, and it has been 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 is not reducible that is probably the cause for your pain. If this is the case, you need to check yourself 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 needs further assessment by 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 head to the nearest ER for a routine investigation and further assessment.


The Probable causes:

Incisional Hernia, colonic mass, Tubo-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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