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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Do Adhesions After Hernia Repair Cause Severe Abdominal Pain?

I had a hernia repair that was entrapped year and a half ago. After surgery I had what I know now was a kinked intestine which eventually broke open and resulted in a removal of 6 of small intestine. (This is after I had complained to my surgeon and the pain was diagnosed as gastritis and did no follow through testing). The part that I am concerned about is that when I arrived at the hospital emergency and my doctor showed up, he proceeded to operate with the diagnosis of a hole in my stomach even though I told him I have never had stomach problems, and had told him of the symptoms that clearly described a bowel obstruction! So the operation took 3 hours of him searching through intestines, scoping the stomach also before finding the perforation and repairing. I now have some bouts of abdominal pain (adhesions?) that seems to last for a few days then gets better. I went to my family doctor when this happened, and he did an xray without contrast that showed I was constipated. I have two questions: Will I have a chronic pain from adhesions from the surgeon handling my intestines and taking a long time/drying out or do they typically keep them wet and practice care in handling? Could the pain I feeling just be from constipation, even though it never caused pain before and would the adhesions cause constipation?
Sat, 10 May 2014
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General Surgeon,  's  Response
HI.
A bit confusing picture.
Let us solve the maize one by one.

You had a surgery for ''entrapped hernia''. This itself predisposes to the chance of recurrent obstruction. Entrapped hernia can ooze a lot of fluid rich in bacteria.
Well this is the first part.

This can cause also a perforation as was told to you. and was repaired too.

Very true - the dried bowel can cause tis. But the first teaching to the Surgeons and the nurses is never allow them to dry-up.
The abdominal fluid is always there and does not allow the drying - this is by personal experience. So forget about drying -up theory.

If the pain started just after the surgery, the kinking/ obstruction is a possibility.

You have undergone surgery one and half year ago and if the pain is of recent origin, it is very difficult to comment upon the cause. It is probably due to constipation and which may in turn be causing recurrent pains.

The best way to see this is called an ''enteroclysis''- meaning contrast X-rays after the tube is passed in the duodenum directly ( helps getting better picture than the routine barium studies. This will help you/us get a clear picture.

A routine enema for evacuation of the bowel is the best solution to find whether this helps relieve the pain or not.
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Do Adhesions After Hernia Repair Cause Severe Abdominal Pain?

HI. A bit confusing picture. Let us solve the maize one by one. You had a surgery for entrapped hernia . This itself predisposes to the chance of recurrent obstruction. Entrapped hernia can ooze a lot of fluid rich in bacteria. Well this is the first part. This can cause also a perforation as was told to you. and was repaired too. Very true - the dried bowel can cause tis. But the first teaching to the Surgeons and the nurses is never allow them to dry-up. The abdominal fluid is always there and does not allow the drying - this is by personal experience. So forget about drying -up theory. If the pain started just after the surgery, the kinking/ obstruction is a possibility. You have undergone surgery one and half year ago and if the pain is of recent origin, it is very difficult to comment upon the cause. It is probably due to constipation and which may in turn be causing recurrent pains. The best way to see this is called an enteroclysis - meaning contrast X-rays after the tube is passed in the duodenum directly ( helps getting better picture than the routine barium studies. This will help you/us get a clear picture. A routine enema for evacuation of the bowel is the best solution to find whether this helps relieve the pain or not.