Incisional epigastric hernia

[suef]

I had a Whipple op in February 2010 for the removal of a tumour from my pancreas. The tumour turned out to be non-cancerous and I have made an excellent recovery.

The operation was done in Belgium, where I was working. I have now returned to the UK and, as part of normal follow-up, have had a CT scan at a UK hospital. This has revealed an 'incisional epigastric hernia containing non-obstructed transverse colon'.

Has anybody else had this type of hernia following a Whipple?

The scan was done in December 2012. When, in February, I asked for the results to be sent to my GP, I was told 'It is not standard practice to forward the results of the scans or bloods to the GP’s unless specifically requested.' Is this normal?

SueF

[PCUK Nurse Dianne]

Hi Sue,

I just wanted to answer your questions. About the incisional hernia, that can be a common complication after any abdominal surgery to be honest. As the abdominal muscles are cut during the surgical process this then requires them to be sutured (stitched) as part of the closing part of the surgery. Unfortunately any operation will immediately weaken the abdominal muscles. Once the muscles have been sutured, it does mean that they are prone to any form of exercise also weakening them further. In most instances after abdominal surgery, it is suggested that the patient does not undertake any physical exercise or straining afterwards for about the first 8-12 weeks (depending upon the type and location of the surgery). Also it is recommended that you do not do any heavy taksis, ie hoovering the floor for the first few weeks, and also lifting heavy articles as this all contributes to weakening the abdominal wall. As time goes by the sutured area stretches and weakens and as you describe some of the bowel loops can become caught in the wound area. This will often cause discomfort and pain for people, and if left too long and the muscles weaken further the bowel can become caught or twisted within the muscles causing an obstruction, this would result in the patient become nauseas, severe pain and also vomiting. This can be corrected by surgical revision of the abdominal wall scar, and in the interim a individually tailored 'bespoke' girdle can be made to help with the issues and relieve the discomfort whilst waiting for surgery.

As for your next question. This would depend upon who requested the CT. If your hospital consultant had requested the CT then the results would have been flagged up to him and/or his specialist nurse. As most GPs are not able to request CT's (I do believe some are, but only in individual centres) I would presume that they possibley did not request yours, so as you have been told, they probably do not send the results to the GP. If the CT request was part of your specialist consultation, it should have been mentioned in your clinic letter that a CT had been requested and results reviewed at your next appointment.

Hopefully that clarifies the questions.

Best wishes,

Dianne

Support Team

[suef]

Dear Dianne,

Thank you very much for this very useful reply!

Best wishes,

SueF