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Forum Name: Gastroenterology Topics

Question: hernia with stomach pulsing


 megie101 - Wed Jun 09, 2010 7:32 pm

Hi there,
I'm a 21 year old female, 5"7 135 lbs and pretty healthy. I noticed about a month ago a small lump a couple inches above my belly button. I can push it back in and it does not cause any pain on the lump itself. I was born with a hernia in the same place but my doctor and parents decided that it had healed itself after watching it for a couple years. I'm assuming it never completely healed all the way and is now protruding out. I went to the health center at my school and she told me just to keep an eye on it and if it got worse to come back in for an ultra sound. Now, my symptoms haven't gotten much worse, everything seems about the same but I am a person who stresses out about everything and I guess I would call myself a a semi-hypochondriac. I sometimes notice soreness around the lump, but this could also be because I mess with it often, making sure its pushed it (I don't want it to become strangulated). Also, today I noticed my stomach pulsing to the same beat as my heart and is so noticeable that it is moving my computer up and down at this very moment! It doesn't hurt, just weird, and I was wondering if it had to do with the hernia. I have been having some mild upset stomach issues, and diarrhea for the past couple of days as well but I don't know if it has anything to do with the hernia. I'm just very busy and stressed with school and work and its hard for me to make time for the doctor, let alone surgery. I would just like to know if this seems like something I should fix right away, or if its okay to just watch it and see if it gets worse. Any suggestions would be really appreciated. Thank you for your time!
 Dr.M.Aroon kamath - Mon Jul 05, 2010 7:57 am

User avatar Hi,
Thank you for this thought-provoking post.

Firstly, the shape of the human abdomen in health does not remain constant during any given 24 hour period. The shape perhaps depends upon
- the time in relation to meals,&
- amount of intestinal contents (solid, liquid and gas) at any given point in time. This obviously will have an effect on the extent of transmission of the aortic pulsations to the anterior abdominal wall.

The pulsations that you observed, are transmitted pulsations of the abdominal aorta, via your abdominal contents (which in turn, caused your laptop to 'pulsate'). In all probability, this has primarily nothing to do with the hernia(which could have at best, served to accentuate it a bit & make it more visible to you).

'True' umbilical hernias are common in children. However, they may occur in adults infrequently (usually in association with conditions causing increased intra-abdominal pressure such as, massive ascitis, obesity, intra-abdominal tumors etc).Some untreated congenital umbilical hernias may go on into adulthood

More common in adults are the 'Para-umbilical hernias', which protrude from a defect in the linea alba close to the umbilicus (usually above the umbilicus).

They usually contain the greater omentum(omentocele). However, sometimes, they may contain the transverse colon or small gut. Frequently, they are multiloculated. Many of them are only partially reducible.These are very prone to get 'complicated' (incarceration, obstruction and strangulation).

Any evidence of redness, tenderness or tenseness should alert to the possibility af strangulation and should lead to an emergency referral to a surgeon. Redness may indicate a srangulation or an infection in a strangulated hernia. Strangulated omentoceles can go on to form abscesses.

In your instance, there are two possible scenarios:
- a congenital umbilical hernia, presumed to have healed completely, may not have healed completely after all, and slowly increased in size, to present during adulthood, or
- that this is a new onset para-umbilical hernia (the congenital hernia had presumably healed fully).

You must consult a surgeon to confirm the nature of this hernia. If it happens to be a para-umbilical hernia, it should be operated upon at the earliest convenience. On the other hand, if it turns out to be a congenital umbilical hernia, even this is better to be repaired as you say that it is sore at times. One should watch out for the aforesaid warning signs of complications and any suspicion should lead to an emergency surgical consultation.
Best wishes!

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