the Difference: Hernia or Tumor in the Abdomen?

Is it a hernia or a tumor?

Hello doctor, I have a lump in the lower right side of my abdomen (close to where it connects to my thigh).
The article mentioned that "the typical symptom of a hernia is the appearance of a bulge in the groin area when standing or straining, such as when sneezing, coughing, or laughing, but the bulge disappears when lying down or when the abdomen is relaxed." However, I do not have a bulge when I exert myself, but when I lie down, there is a long-shaped bulge on the right side, although it does not appear every time I lie down.
I have not gained weight, but my lower abdomen used to be flat and is now protruding.
I initially thought it might be a gynecological issue and consulted a gynecologist (who performed an ultrasound), but nothing significant was found.
I am unsure if this could be a hernia.
What causes hernias in women? Would surgery have any implications for women? If I need to see a specialist, which department should I consult (Family Medicine? Surgery? Gastroenterology?)? I am concerned whether this could be something like colon cancer or a tumor.
I would greatly appreciate your insights!

Kunrao de ren, 20~29 year old female. Ask Date: 2007/10/10

Dr. Zhuang Renbin reply Surgery

Dear Sir/Madam,
Based on your symptoms, it seems less likely that you are experiencing an inguinal hernia.
However, in females, diagnosing a femoral hernia often requires a physical examination.
Additionally, subcutaneous tumors or lymphadenopathy also necessitate a physical examination before arranging further imaging studies for diagnosis.
Therefore, we recommend that you schedule an appointment with a general surgery outpatient clinic.
We are more than happy to assist you.
Wishing you good health and all the best from the Department of Surgery at Tainan City Hospital.

Reply Date: 2007/10/10

More Info

When it comes to distinguishing between a hernia and a tumor in the abdomen, it is essential to consider the characteristics of the lump you are experiencing, as well as the symptoms associated with it. Based on your description, it seems that the lump you feel in your lower right abdomen near the groin area does not behave like a typical hernia. Hernias usually present as a bulge that appears when you are standing or exerting yourself, such as during coughing, sneezing, or laughing, and typically disappears when lying down or relaxing. In your case, you mentioned that the lump does not appear when you exert yourself, which is atypical for a hernia.

The fact that you feel a long, strip-like structure when lying down, which does not always protrude, raises the possibility of other conditions. It could be a variety of things, including a lipoma (a benign fatty tumor), a fibroma, or even a lymph node enlargement. Since you have already consulted a gynecologist and had an ultrasound that did not reveal any significant findings, it may be beneficial to seek further evaluation from a general surgeon or a specialist in abdominal conditions.

Hernias can occur in women due to several factors, including congenital weaknesses in the abdominal wall, previous surgeries that may have weakened the area, or increased intra-abdominal pressure from activities such as heavy lifting, chronic coughing, or even pregnancy. Surgical intervention for a hernia typically involves repairing the defect in the abdominal wall, and while there are risks associated with any surgery, most women recover well without long-term complications.
If you are concerned about the possibility of a tumor, it is crucial to have a thorough evaluation. While the ultrasound did not show anything alarming, if the lump persists or changes, further imaging studies such as a CT scan or MRI may be warranted to provide a clearer picture of what is happening beneath the surface.
In terms of which specialist to consult, starting with a general surgeon would be a good choice. They can perform a physical examination and determine if further imaging or intervention is necessary. If they suspect a specific type of tumor or other conditions, they may refer you to an oncologist or another specialist for further evaluation.

In summary, while your symptoms do not strongly suggest a hernia, it is essential to continue seeking medical advice to rule out other potential causes for the lump in your abdomen. Early diagnosis and intervention are key to managing any abdominal issues effectively. Please ensure you follow up with a healthcare provider who can guide you through the next steps based on your specific situation.

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