my wife had a hernia operation 5 years ago, and developed a seroma the size of a rugby ball protruding from her stomach, which is still present and is not going anywhere, and she has pain in that area, which is so bad she is on morphine, and has been on morphine for the last 3 years. The surgeons performed the hernia operation and sent her home the next day, and never attempted to drain the fluid, has anyone got any helpful information. Can supply photo' s later.
What Can Be Done for my Wife's Seroma?
Doctor Answers 9
First, you must confirm your supposition that this is a chronic seroma. A CT Scan with contrast or an MRI with weighted images will assist in this endeavor. If it is a chronic seroma as you have described the most definitive treatment will be excision of the seroma cavity, progressive tension sutures of closure and drainage. This is very likely to leave an indention in the area of the previous seroma. Sclerotherapy of a seroma cavity of such long duration is most likely going to fail. May I suggest you seek out a member of the ASPS in your area to help you and your wife. Best,
Gary R Culbertson, MD, FACS
I would start with a CAT scan to confirm this is aseroma. If it is then she will nedd additional surgery
What Can Be Done for my Wife's Seroma?
This is a terrible story, to hear this has apparently been ignored for 5 years.
This should be evaluated and treated. Start by bringing her to a surgeon with expertise in the abdominal wall. Depending upon where you live this could be a general surgeon or a plastic surgeon. Whichever you choose you may find the surgeon will consult with the other to work as a team.
The evaluation should include a CT scan to look for recurrence of the hernia and to document the fluid collection. The surgery at this stage will probably be complex and involve removal of the entire lining of this large cavity, and then an effort to put the pieces back together.
If you live near a University Medical Center, that might well be your bet best.Thanks, and best wishes.
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Chronic Seroma Treatment
Once the diagnosis is confirmed with imaging, the area can be excised and will create a contour abnormality initially. I have had consultations for this multiple times, and I sometimes excise this first and then fat graft the area later to create a flat contour. However, depending upon size, location, and looseness of skin, this chronic seroma cavity may be removed and a modified tummy tuck performed. Consultation with a board certified plastic surgeon or pictures would be recommended.
Treat Long Term Seroma?
I'm sorry to hear about the complications your spouse has experienced after hernia surgery. I'm sure, over the course of the past 5 years, she has had extensive workup performed. Therefore, what I am about to recommend will probably be redundant.
I would suggest CT scan imaging of the abdominal wall to rule out recurrent hernia and to evaluate the nature and extent of the fluid accumulation.
If it turns out, that your wife is dealing with a chronic seroma, then I would suggest that you work with a well experienced, reputable board certified plastic surgeon in your area. More than likely, surgical excision of the scar around the seroma (“bursa”) will be necessary. I would then close the abdominal wall skin over several suction drains.
I'm glad to hear that your wife has your much needed support.
How to treat your chronic seroma
First of all its appauling this has gone unchecked for 5 years and now your wife is addicted to Morphine. The source of the seroma has to be checked. If there is not fistula with any internal bowl sources which can be ruled out with CT scar and dye studies. This seroma needed to be addressed surgically. Essentially the entire shell or capsule of the seroma needs to be excised and then a drain placed. Tissue adhesives such as Tissell may be helpful to obliterate the dead space along with the use of a compressive garment which should be worn for at least a month after surgery. No exercise for at least 6 weeks.
Long standing Seroma or Recurrent Hernia
I agree with the other expert that a general surgery consult is warranted with a CT of the abdomen with contrast to identify a seroma cavity or a recurrence of the hernia.
5 year seroma
Need a general surgeon to see you and order ct with oral contrast. Next step hard to say until more information is obtained.
Seroma after hernia repair
I would consult with another general surgeon, and maybe a plastic surgeon. It all starts with a physical exam and from there could include a CT scan or other imaging. If it is a large seroma potentially it could be excised and repaired (maybe over a drain). Or injected with a "sclerosant". There are options. Best of luck to you.