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Answer to your Health Question

Question (06/30/2013):

Title: Help understanding CT report for right flank pain.

There is fatty infiltration of the liver.

There is a hernia containing portions of the urinary bladder just above the pubic symphysis and to the left of the midline.

There is a right-sided mid abdominal wall defect which contains fat.

There is mild fat inflammation which may be incarcerated fat or scar.

There is adjacent inflammation that is located in the most lateral aspect of the surgical incision scar.

There is a small amount of fat edema but this mainly involving the adjacent subcutaneous fat and not the mesenteric/interperitoneal fat.

This could indicate incarcerated fat.

In Feb. 2012 surgery was done for multiple obstructions and adhesions of the intestines.

In January 2013 a surgery was done for surgical complications of the 1st surgery.

A large inflammatory mass was removed and multiple draining fistulas were drained.

The sutures from the 2 inner most layers were removed and replaced with permanent ones.

Fat and muscle tissue was trimmed away and wound debrided and closed.

Answer:

Thank you very much for your question.

Fatty liver, also known as fatty liver disease (FLD), is a reversible condition where large vacuoles of triglyceride fat accumulate in liver cells via the process of steatosis (i.e. abnormal retention of lipids within a cell). Despite having multiple causes, fatty liver can be considered a single disease that occurs worldwide in those with excessive alcohol intake and those who are obese (with or without effects of insulin resistance). The condition is also associated with other diseases that influence fat metabolism.

The urinary bladder is the organ that collects urine excreted by the kidneys before disposal by urination.
Herniation of urinary bladder is a relatively uncommon however not rare condition, where urinary bladder or ureter herniates into the inguinal canal, scrotal sac or femoral canal.

Herniation of bladder is seen in 1-3% of inguinal hernias. It is seen in 10% of men older than 50 years. Femoral hernias are more common in women. These hernia has a predilection for right side.

Abdominal Wall defects are a type of congenital defect that allows the stomach,the intestines, or other organs to protrude through an unusual opening that forms on the abdomen.

Incarcerated fat is confined fat, fat cells may cause inflammation.

The wound-healing process begins with inflammation.

Subcutaneous edema is a fluid accumulation below the skin.

Adhesions are the internal scars that form in all of us as we heal from an infection, inflammation, surgery or trauma. Adhesions can cause a number of conditions, including chronic pain, female infertility, bowel obstruction and pelvic dysfunction.

Adhesions in the abdomen pull on parts of the intestines and sometimes cause an obstruction.

An inflammatory mass on the abdominal wall after surgery may pose significant diagnostic and therapeutic problems and may raise concerns about the true pathogenesis of such an entity.

Preventive measures to reduce the incidence of adhesions are the mainstay of limiting the complications related to adhesions.

These include using minimally invasive surgical procedures, meticulous surgical technique, keeping tissues moist, reducing bleeding and the use of adjuvant adhesions prevention barriers to keep the tissues from sticking to each other.

Once adhesions form, they are hard to get rid of.

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