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Dr. David
Dr. David, Board Certified MD
Category: Medical
Satisfied Customers: 46943
Experience:  Board Certified Physician
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I had a c section November 2014. Healed well no problems.

Customer Question

I had a c section November 2014. Healed well no problems. Started noticing a pulling pain in lower left side of belly button when exercising and lifting my son around May 2015 the pain gradually got worse and in March 2016 whilst lifting I had a very sharp pulling pain going all the way from my belly button down to my c section scar on the left side. It felt as if something had torn. I have been in agony since and i am unable to lift my son, work or drive without being in extreme pain. I cant wear pants as it really aggravates it, when I laugh or cough also. If i stand up to quick without supporting my stomach it really pinches and hurts inside almost as if something is caught on something inside. I have had an mri which has shown a 1cm granuloma thought to be a suture granuloma within the rectus sheath. Can this be causing this much pain? And how has it taken so long for it to be causing problems? Would i of healed so well from c section in the begining if it is a suture granuloma?
Submitted: 1 year ago.
Category: Medical
Expert:  Dr. David replied 1 year ago.

This is Dr David

you need to be checked for abdominal ventral and umbilical hernias

after C sections, you can have weakness of your abdominal lining in the area of surgery which can cause hernias where bowel can press through areas of weakness and get caught and cause severe pain

and abdominal examination and abdominal ultrasound can check for hernias of bowels pushing out through your area of prior surgery.

yes, a 1cm granuloma could also be causing severe pain.

granuloma is scar tissue the body forms to foreign bodies.

you might have to have another surgery procedure to have that granuloma and suture removed if it is pressing on a nerve close by causing pain.

let me know if you have other questions.

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Customer: replied 1 year ago.
Thanks for your quick reply, i have had two ultrasounds to check for hernias, muscle tears and the only thing found was the granuloma. Mri also shown no weakness in the abdominal wall. Do you think I could have adhesions also? I have pain behind my belly button too, and all the bottom of my stomach feels tender. Everytime i bend forward I feel something pinching and pulling inside. Is there anything else you think this could be? Thanks
Expert:  Dr. David replied 1 year ago.

yes, any surgery can cause scar tissue and adhesions around small bowel which can cause severe pain and nausea and sometimes vomiting.

I'm glad they didn't find any hernias.

I would check with your doctors about another surgery to remove that granuloma

and they may have to go in and cut out scar tissue like a procedure called lysis of adhesions to get rid of scar tissue on the lower anterior abdomen from your prior C section

a general surgeon would tend to do this type of surgery.

let me know if you have other questions.

if done for now, please leave positive rating of 3-5 stars so I can get credit for helping you today

we only get credit for helping clients after positive feedback

you can always reach me directly with "a question for Dr. David" in the medicine or oncology categories if you have other questions

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http://www.justanswer.com/medical/expert-dr-david/

Thanks for using JustAnswers.com

Expert:  Dr. David replied 1 year ago.

do you have any other questions?

Customer: replied 1 year ago.
Thanks, ***** ***** an appointment with my surgeon next week. I am just concerned how I seemed to be ok for a long time after the c section then only when I started exercising and returned to work that I started experiencing the pain I work as a nursing assistant on a heavy ward so do a lot of lifting. On the day I experienced the sharp tearing pain March 2016 It was during work whilst I was lifting a patient and the pain has been severe ever since could it be possible for it to be caused by straining? Should I have felt pain and discomfort immeadietly after the c section with a suture granuloma or is this something that can develop over time? Thanks
Expert:  Dr. David replied 1 year ago.

I'm glad you have an appointment with the surgeon.

sounds like that heavy lifting episode caused that sharp tearing pain

it does sound like that granuloma is close to where that pain is for you.

it can take months sometimes for granulomas to form around a foreign body.

that is probably why it took more than a year before the pain got bad there.

let me know if you have other questions.

if done for now, please leave positive rating of 3-5 stars so I can get credit for helping you today

we only get credit for helping clients after positive feedback

you can always reach me directly with "a question for Dr. David" in the medicine or oncology categories if you have other questions

here is my website if you need to reach me:

http://www.justanswer.com/medical/expert-dr-david/

Thanks for using JustAnswers.com

Customer: replied 1 year ago.
Thanks so do you think the the episode of heavy lifting which caused the sharp pain was just a coincidence that it is in the same place as the granuloma? Would adhesions cause pulling and pinching pain when straining the abdomen? Thanks
Expert:  Dr. David replied 1 year ago.

no, I think the granuloma is pressing on nerves close by and when you lift or strain this causes the granuloma to press on nerves causing pain.

adhesions and scar tissue could also cause pulling and pinching pains when straining the abdominal muscles

Dr. David and other Medical Specialists are ready to help you
Customer: replied 1 year ago.
Thanks, ***** ***** think the granuloma can be removed through keyhole surgery and any possible adhesions?
Expert:  Dr. David replied 1 year ago.

yes, granulation tissue any any possible adhesions can be removed through laproscopic keyhole surgery.

Customer: replied 1 year ago.
Hi, I have seen a general surgeon who feels that the structure found within the rectus sheath is not a suture granuloma as I would not have been stitched in this area with the c section and this is the only abdominal surgey i have had. It is described as a 9x7mm heterogenous lesion deep within the rectus sheath. After doing some research of my pain and symptoms I have come accross anterior cutaneous nerve entrapment syndrome and I feel I could have this. Could the lesion found be a trapped nerve are you able to see this on a ultrasound or mri? Thanks
Expert:  Dr. David replied 1 year ago.

yes, the spot could be trapping a cutaneous nerve and causing pain.

did the general surgeon say he could cut it out?

Customer: replied 1 year ago.
No as he cant feel it on the outside he said hes not willing to remove it as it is only small and it would be like looking for a needle in a hay stack, the pain i am having is most certainly nerve pain what I would like to know is can the structure shown on the mri scan be a trapped nerve?
Expert:  Dr. David replied 1 year ago.

yes, it could be trapping a nerve.

Customer: replied 1 year ago.
What would be the treatment for this?
Expert:  Dr. David replied 1 year ago.

surgery could cut out that spot, but it could possibly injure the nerve as well.

so there would be risk for having the surgery.

Customer: replied 1 year ago.
Which type of surgeon would perform this? What do you think could have caused the spot to form in this area?
Expert:  Dr. David replied 1 year ago.

I general surgeon could potentially do this surgery.

it is unknown what could have caused this spot to form.

Customer: replied 1 year ago.
Have you heard of anterior cutaneous nerve entrapment syndrome? After reading up on this I have all the signs and symptoms and would like to know who I would need to see about a neurectomy
Expert:  Dr. David replied 1 year ago.

you can see a nerve surgeon or neurosurgeon or a general surgeon to have this nerve cut out

but this can be difficult to do for small nerves

some small nerves are so small, we can't see them with human eyes.