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Lump in Abdomen?

Q. I noticed the other day that I had a lump in the lower part of my abdomen. A friend of mine said it may be a hernia. How do I tell, and what should I do?

A. The most common causes of lumps of the abdominal wall are hernias and lipomas.

Lipomas are benign tumors of fatty tissue and will grow right where they are but won’t spread to other parts of the body. They can cause discomfort and may need to be removed if they are in places besides the abdominal wall where they can cause problems. Lipomas are most often confused with another “lump” that can occur on the abdomen called a hernia.

A hernia is just a hole in the connective tissue that lies underneath the skin. Contents of the abdomen— fat, intestines, etc.—can protrude through that hole and cause a lump. Most of the time, a hernia lump will “go away” when you lie down and “come back” when you stand back up.

The difference between the two lumps is important because the hernia and its contents can cause considerable pain and other problems if the tissue caught in the hole gets squeezed and has its blood supply compromised. Worse, if the tissue in the hernia has the blood supply cut off, i.e. a strangulated hernia, it can be life threatening. Any hernia could become strangulated but most don’t. They just cause a lump that can enlarge over time as the hole enlarges.

Any lump should probably be checked out by your doctor, and you might be asked to see a surgeon if your lump becomes painful.

David Redd, M.D.

FACS, Chattanooga Hernia Center

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