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How can pain at the site of incision after appendicitis surgery be treated?

Q: My 14 years old nephew got his appendicitis operated in six months back. After the surgery, he has been experiencing acute and continuous pain at the incision point. He cannot sleep at night due to the pain and has even stopped going to the school. The doctors initially identified it as a hypertrophic scar and treated him for three months. But the pain didn’t reduced. We have consulted another doctor lately who suspects it to be a scar neuroma. How can this be treated?

A:If he truly has a hypertrophic scar, it is usually better to wait. If it is a scar neuroma, it will need a small operation. Scar neuromas are very rare, so I am not sure if this is the correct diagnosis. I suggest:

  • Take a third opinion, from a senior surgeon
  • Ask the surgeon to rule out a hernia at the operative site. Small hernias are not uncommon after surgery, and can cause pain.
Sometimes, the only way to confirm a small hernia is by a CT scan. (Surgeons do not like to order a CT scan for diagnosing a hernia, so you may have to insist with your practitioner.)

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