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  • At a loss - no diagnosis

    This is sounding pretty familiar. My 16 year old daughter suddenly started having pain in her lower right abdomen area. Since it persisted a week, we went to the Dr. She ordered an ultrasound which showed multiple ovarian cysts. Gyn put her on the pill and said come back in 3 months. 2 months later we had another ultrasound. This showed the cysts were gone, but the pain was still constant. It was not related to her period or to eating or not eating. Exercise and activity intensified it. Next had a CT scan. They couldn’t get the dye injected but she did drink some of the other imaging liquid. Nothing found although both US and CT scan report say a “large amount of stool” and that she’s probably constipated. She isn’t. The CT scan did mention that she might have a small Meckel’s diverticulum. Next did the nuclear med scan for gastric tissue. Negative. Pain now constant and severe. Last step: we just had a diagnostic laparoscopy. Results: everything looks normal!! Didn’t even see the diverticulum. My poor girl just cried when she came out of surgery and was told. Then I found this site. It seems to fit but wouldn’t the surgeon have seen the hernia? Please note that her brother had an inguinal hernia repaired at Sholdice when he was 18. Any help would be greatly appreciated!

  • #2
    Dr. Towfigh has written quite a bit about "hidden", or occult, hernias. You can find a lot on this forum, and on the internet if you search those words and her name. Send her a message or contact her office directly.

    Here is some information from her practice's web site -

    https://www.nytimes.com/2011/05/17/health/17brody.html

    http://www.beverlyhillsherniacenter....es-of-hernias/

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    • #3
      I'm sorry to hear about your daughter.

      Is the pain in the typical region of a groin hernia, in the general inguinal or femoral region?

      Was the ultrasound specifically looking for a hernia of the groin, performed with valsava? Or was it just looking at the general abdomen? These are typically different ultrasounds and do not overlap, so it would be worth confirming.

      Presumably she has been tested for intermittent or chronic appendicitis? Does she have rebound pain upon pressure release?

      Checked for endometriosis? PCOS?

      Do any particular foods make it worse? Have you tried an elimination diet to rule out anything that could be dietary related? Or some other GI issue like IBS or Crohns?

      Sorry, I am not a doctor and am just tossing out a few ideas. Hopefully you'll find a physician that is a good diagnostician that can help go through a workup.

      In terms of CT / MRI, it may be helpful to have a hernia expert look at them just in case they see anything notable. As "Good Intentions" mentioned, Dr Towfigh will review scans, as will some other physicians that are often mentioned on these forums.

      What region of the country are you located in? Perhaps someone is aware of a regional expert.

      Best of luck, keep us updated on her case and your progress.
      Last edited by Chaunce1234; 04-16-2018, 07:09 PM.

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      • #4
        Update,
        Unable to accept that there was nothing wrong, and with my daughters symptoms not only persisting but increasing, I sent my surgeon Dr Towfigh’ 2014 JAMA article and some newspaper articles on occult hernias. Luckily he had an open mind and called her in for re-examination. He still couldn’t feel anything but admitted, even during the diagnostic laparoscopy, that he was not looking for a hernia. He also said that, with the new information in mind, that her pain was exactly where an inguinal hernia would be. So he went ahead and ordered an MRI!
        Unfortunately we’ve had to wait months because manu of the radiologists “ don’t believe this is an acceptable use of the MRI’s time” so they won’t schedule it. Only 1 hospital did, but I have big fears that they may not follow the procedure that would best show this. Her MRI is today, so all my fingers and toes are crossed. Otherwise, I may have to visit Dr Towfigh in person as she is now not able to consistently attend school in her final year due to the pain.
        Last edited by Jjpugsley; 5 days ago.

        Comment


        • #5
          Originally posted by Jjpugsley View Post
          Update,
          Unable to accept that there was nothing wrong, and with my daughters symptoms not only persisting but increasing, I sent my surgeon Dr Towfigh’ 2014 JAMA article and some newspaper articles on occult hernias. Luckily he had an open mind and called her in for re-examination. He still couldn’t feel anything but admitted, even during the diagnostic laparoscopy, that he was not looking for a hernia. He also said that, with the new information in mind, that her pain was exactly where an inguinal hernia would be. So he went ahead and ordered an MRI!
          Unfortunately we’ve had to wait months because manu of the radiologists “ don’t believe this is an acceptable use of the MRI’s time” so they won’t schedule it. Only 1 hospital did, but I have big fears that they may not follow the procedure that would best show this. Her MRI is today, so all my fingers and toes are crossed. Otherwise, I may have to visit Dr Towfigh in person as she is now not able to consistently attend school in her final year due to the pain.
          Any update on your daughters case?

          Comment

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