Acute on Chronic Abdominal Pain

I AGREE TO USE MD STAT FOR EDUCATIONAL PURPOSES ONLY, THAT NO DOCTOR PATIENT RELATIONSHIP IS FORMED BY MY PARTICIPATION IN THIS EXCHANGE, AND I UNDERSTAND THAT MY QUESTION AND ANSWER(S) WILL BE POSTED ON THE WEBSITE AND WILL BE VIEWABLE BY VISITORS TO THE SITE.: Yes, I agree.

6 months ago my 3 yr old landed a perfect knee to my solar plexus causing intense pain and vomiting. A month later he did it again. I am now very sensitive there. Last week while dusting myself off a lite pat to the area created considerable discomfort for the rest of the week. Saw family doc on Thursday. They feel it acid reflux. I didn't have discomfort until I was hit. Lucky me, my son landed another one last nite while giving me a hug. I'm able to flex 6 pack abs and pecs, do push ups everything as normal. I can take deep and shallow breaths normally. Normal appetite. Normal digestion and movements. Normal sleep. The problem is a constant mild to  dull radiating pain in my solar plexus area. It almost feels like a hollowness in the center of my chest behind the muscles and sternum. Sounds a little strange but not sure how to describe.


Gender: Male
How tall are you (feet and inches)?: 5 10
What is your weight in pounds?: 175
How old are you?: 39
How long has this been going on?: A week or two
Check all symptoms you are currently experiencing: Chest Pain
What have you done so far to remedy this condition? Please include tests and relevant studies here. Blood work for Gall Bladder and Pancreas. Results normal.

Please list any chronic medical problems and also list any prior surgery: Total Hip Replacement
Appendectomy

Are you currently using or do you have a history of tobacco use?: Yes
Are you currently using or do you have a history of illegal drug use?: No
Please describe your alcohol consumption :: Daily

HOW QUICKLY DO YOU NEED THIS TO BE ANSWERED?: As soon as possible.

Can you bruise the solar plexus?
What is the best method of diagnosis for a non muscular skeletal injury?
What are possible treatments?
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Sir, 
This is a puzzling case indeed. 

Can you bruise in the solar plexus? Well, you can get an abdominal wall bruise, but six months ago? If this were the cause then you should be well by now.

The next question is the real money question... What is the best method of diagnosis? The answer is a contrasted CT Scan, perhaps an MRI of your abdomen and pelvis. 

I think you should have this as soon as possible. I think your logic is sound in thinking back to the incident with your three year old, but from a doctor's perspective, I am concerned about your story. 

The nature of the pain concerns me. The chronicity of the pain concerns me. In short, being ER trained, I think automatically of the worst possible cause, and this is, of course, cancer. Do I think you have it? No, but it IS on the list. As long as it is 'on the list' it's time to take it off the list as quickly as possible. This requires imaging studies as mentioned above.

You can not rule out disease of the pancreas or gall bladder with blood tests, though the results can suggest disease. It's time for you to get back with your family doctor and let him know that your pain has been present for six months. And it's time to request either a CT scan of your abdomen or pelvis, OR, referral to a GI specialist or surgeon. 

If you have questions about my answer please leave them in the comment section. 

Be well

Sudden, Painful, Abdominal Wall Bulge

I AGREE TO USE MD STAT FOR EDUCATIONAL PURPOSES ONLY, THAT NO DOCTOR PATIENT RELATIONSHIP IS FORMED BY MY PARTICIPATION IN THIS EXCHANGE, AND I UNDERSTAND THAT MY QUESTION AND ANSWER(S) WILL BE POSTED ON THE WEBSITE AND WILL BE VIEWABLE BY VISITORS TO THE SITE.: Yes, I agree.

I was practicing Yoga today, lifting myself up in a pose that uses arms, and lifts the legs up, so there is a lot of pressure in the abdominal muscles, suddenly I felt a sharp pain 2 centimeters to the right side, and one centimeter down of my solar plexus, I had to stop the pose, and touched what it felt like a bump, maybe a hernia, it was really painful, I put some pressure and it went down, but I still feel a little pain, and I'm concerned as to what that could be. I had to put a few days ago because the site wouldn't let me leave it at started today, but this, started today.

Gender: Female
How tall are you (feet and inches)?: 5'7
What is your weight in pounds?: 123
How old are you?: 43
How long has this been going on?: A few days

Describe associated symptoms not listed above: I had a really bad cold, was bedridden for almost 13 days, first 3 days I had a fever and chills, I was so tired, I got up on day 13, I'm still not strong enough, this was 4 days ago when I got up, I feel as though my body aches, which it does because I also teach Yoga and practice daily. I haven't been eating as much as I usually do, I'm a raw vegan, I'm very healthy, but I have some stress going on in my life now so I haven't been very diligent or disciplined when it comes to eating.

What have you done so far to remedy this condition? Please include tests and relevant studies here. Just happened today, pushed the bulge down.

Please list any chronic medical problems and also list any prior surgery (lacerations don't count!): I've had 2 myomectomies, 2 laparotomies to remove uterine fibroids, and a cyst in the right ovary. I've also torn L4 and L5 a year and a half ago.

Please list any medication allergies that you have : : None that i know.

Please list any medications you are currently taking (and dosage if known) :: I started taking Opti Gyn Formula from Eclectic Institute. I have uterine fibroids and don't want to get surgery yet again, besides they pressure my bladder so I cannot get over 4 hours of uninterrupted sleep, sometimes even less than that.

When was your last menstrual cycle?: 2 weeks ago
Are you currently using or do you have a history of tobacco use?: No
Are you currently using or do you have a history of illegal drug use?: No
Please describe your alcohol consumption :: Never

I'd like to know what this is and the steps I should take. I'd like to know whether I can shrink the fibroids without surgery and whether there is something I can take to stop going to the bathroom all night so I can sleep.

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So I think it is fairly safe to say that you have given us the textbook definition of an abdominal wall hernia here in your question. The fact that it occurred suddenly during exertion and produced a  bulge in the abdominal wall is nearly diagnositic. 

Abdominal wall hernia's are not as common as umbilical hernias or inguinal hernias, but they do occur, and they do require repair by a surgeon. 

This link here might be helpful to you, I'm not sure, you seem to understand what a hernia is but I will provide it for your information.

Strangely, it is the small hernias that are the most dangerous. For this reason I think it is critical that you see a surgeon soon to get this looked at. Small hernias are prone to 'incarceration' which can lead to 'strangulation', where the herniated tissue becomes trapped and dies. This then can lead to rupture and peritonitis and then, instead of an elective repair of a small hernia defect, you face major surgery and days if not weeks in the hospital. 

My recommendation about your second question is simply that you consider a hysterectomy. At age 43 you are likely not thinking about having children, and I can only assume that the myomectomies were performed in an attempt to preserve fertility. There is no medicine that will allow for you to sleep through the night as the problem is mechanical, the fibroids are compressing the bladder. 

Interestingly, since it is likely you will need surgery for this hernia that we think you have, you might be able to get the hernia repair and a laparascopic or trans-vaginal hysterectomy done at the same time. This will require agreement between two surgeons (not an easy feat), but it's certainly something I would pursue if I were you. 

Finally, if you have not had your blood count checked lately you will want to do that. Uterine fibroids, with the chronic bleeding that often accompanies them, can cause ANEMIA, and it may be that you have anemia and are experiencing some of the common symptoms associated with it (link provided). 

If you have any questions about my answer please ask them in the comment section. Thanks for your question, and good luck!