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Knot under c-section scar

Hello all. I am a 26 year old, 6month PP mother of a beautiful little girl. I had a great pregnancy with no complications following a very successful c-section. About a month or so after my c-section I noticed a small knot under the left side of my c-section. It was a little painful, so when I went for my 6 week check-up I brought it to my OBGYN's attention. He explained to me that it could be from where he tied the knot for my sutures, or it could be a little scar tissue...but that it was nothing to be concerned about and I looked great and sent me on my way. Recently however, I noticed that the left side of my incision is a little bit more raised than normal, and is somewhat sensitive when pressure is applied to the area (nothing to be concerned about, as it as always felt this way, and is normal after having a c-section) One side, I know, is supposed to be a little more tender than the other. I went to the Doctor today, thinking I had a kidney infection b/c my lower back (on the left side) was hurting really bad. No kidney infection, so the Doctor (not my OBGYN...family practitioner) started kind of poking around on the left side of my stomach and I brought it to his attention that my scar from my c-section had been a little tender for this past week...I am no scheduled to have an Ultrasound to see if I may have an incisional hernia in that area...is it possible to have a small hernia without having any "bulging" or visible signs of one from the outside? Also...if there is not a hernia or an adhesion...what is the next step? I don't have much pain there, it's just noticeably uncomfortable. Any help or info would definitely be reassuring to say the least.
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It could be a hernia, even without bulging.  If it is, it will need to be repaired.  I wonder though, whether it is still related to the suture.  I don't know what type of suture your MD used, but some of them take 3-6 months to reabsorb.  If you are a thin person, and he used a suture such as PDS, it could still be the knot, OR it could be that you are developing a little stitch abcess. It is fairly common to get a small infection at the site of the knot--it usually is like a little pimple or boil.  If it is an infection, it will get more tender and swell more, and probably turn red. Eventually it will come to the surface and "pop" like a pimple.  If there is an abcess, this will likely show up on your ultrasound, and can be treated with antibiotics.
If the ultrasound is normal, you can probably just wait a little longer to see if it goes away on its own.  It takes at least 6 months to heal completely.
I hope this is helpful!
Congratulations on your new arrival--motherhood is the BEST!
Good luck!
Dr B
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