Any surgery that involves an incision in the abdomen is at risk of causing a bulge in the surgical site, also known as an incisional hernia. At least 33 percent of patients who undergo abdominal surgery are at risk of developing this condition.
An incisional hernia occurs at or near a surgical incision. This condition is characterized by protrusion of the intestines, abdominal organs, or other tissue surrounded by the skin of the abdominal wall.
Incisional hernias most commonly occur within 3–6 months after abdominal surgery. However, a bulge on the surgical site in the abdomen can also occur months or years later.
At first, you may notice a small lump or swelling near the site of the surgical scar. The lumps appear when you cough or strain, and then go away on their own. However, over time, the lump may get bigger and start to hurt.
In the vast majority of cases, this bulge at the surgical site does not cause any serious problems. However, in rare cases, part of the intestine may become trapped in the hernia opening and block the passage of feces or stop the blood supply to the intestine, causing an emergency.
In addition, a large bulge in the surgical site of the abdomen can also make it difficult for you to breathe or move normally.
What Causes a Bulge on an Abdominal Surgery Scar?
A bulge in the abdominal surgery scar occurs if the surgical wound in the abdominal wall does not close completely after surgery. This can cause the abdominal muscles to become weak, allowing the tissues and organs in the abdomen to protrude as a hernia.
The following are some things that can prevent the surgical wound in the stomach from healing properly:
- Too much pressure on the stomach during wound healing
- Pregnant before the wound in the stomach heals completely
- It's too soon to return to physical activity after abdominal surgery
What are the risk factors for a bulge in the former abdominal surgery?
There are several factors that can increase the risk of a bulge in the former abdominal surgery, including:
1. Surgical wound infection
If not treated properly, postoperative sutures are at risk for infection. Infection will not only make it difficult for the stitches to close completely, but also pose a risk of protruding the surgical site and hindering the overall healing process.
2. Co-morbidities
Certain diseases, such as kidney failure, diabetes, and lung disease, can put pressure on the abdomen and interfere with the healing process of surgical wounds. This can increase the risk of reopening the sutures and triggering a bulge in the surgical wound.
3. Excess body weight (obesity)
Excess weight can put pressure on the surgical scar or greater scar tissue, increasing the risk of an incisional hernia. In addition, this condition can also hinder the wound healing process.
4. Smoking habit
Smoking habits can also increase the risk of a bulge in the surgical wound. This is because the content or chemicals in cigarettes can inhibit the body from repairing damaged tissue and make surgical wounds difficult to heal.
In addition to some of the risk factors above, the consumption of certain drugs, such as immunosuppressant drugs or steroids, can also increase the risk of incisional hernias.
How to treat a bulge in the surgical scars on the abdomen?
If you experience a bulge in the former abdominal surgery, you should immediately consult a doctor. In addition to a physical examination, the doctor will also carry out supporting examinations in the form of an abdominal ultrasound or abdominal CT scan if necessary.
If the protrusion is small, surgical repair may be an option, but is not mandatory. However, if the bulge is large enough, there is a pinched part of the intestine, or it causes pain, your doctor will recommend surgery.
Although it can be said that it is common after surgery on the abdomen, bulges in the surgical scars can be prevented by good surgical wound care, not doing strenuous physical activity during recovery, and leading a healthy lifestyle.
If during the recovery period you have a fever, the surgical wound looks swollen, pus, smells, or bleeds, immediately consult a doctor so that appropriate treatment can be carried out.
Written by:
dr. Sonny Seputra, M.Ked.Klin, Sp.B, FINACS
(Surgeon Specialist)
