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Saturday, August 07, 2010

What else could a Lipoma be?

In a follow up to the post on What else could an Umbilical hernia be? a strikingly similar experience prompts this post.

A fairly large lady of middle eastern descent presented to us with a soft, non expansile, mobile, swelling over her left thigh just about where the groin fold meets the leg. She said she'd had it for years and it gave her no trouble other than cosmetic and she wanted it taken out for that specific purpose.

She underwent a Sonogram which confirmed our clinical diagnosis of it being a Lipoma. Happy with our findings we posted her for surgery under local anaesthesia (which is usually the case) in day care!

We started off, dissected around it, it looked like a lipoma and we dug deeper and higher. Down to the muscle layer, carefully avoiding the femoral vessels. Until we reached what we thought was the femoral canal. She was under local so we asked her to cough. No impulse. Asked her again. No impulse. No luck either as my finger was going all the way up through what was now confirmed as the femoral canal.
This was no lipoma. It was a full fledged femoral hernia!

Luckily the anaesthetist was close by and was able to reach us in 10 minutes. We carried out the repair completely and the lady is doing fine.

I wonder what else a lipoma could be? Until I find another presentation.....

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