Abdominal hernia refers to a tear in the abdominal wall that allows the abdominal organs or fatty tissues to protrude through the cavity holding the organ. The tear occurs due to the weakness of the muscles surrounding the wall and causes a bulge in the affected area. The bulge tends to enlarge with cough or any other activity that puts pressure on the abdominal muscles and the size of the hernia reduces when the patient is rested or made to lie down. Hernias normally occur in males; however infants and women are also prone to this condition.
Abdominal hernia can be classified into reducible hernia and non reducible hernia. In case of reducible hernia, bulge can be pushed back into the sack with mild pressure and surface can be flattened in the affected area. But in few acute cases, hernia cannot be pushed back into the cavity and this condition is known as non reducible hernia. This is a medical emergency as it poses the risk of strangulation. In case of strangulation, blood supply to the herniated tissue will be cut off leading to the death of the tissue. If the intestines get strangulated and eventually lose blood supply, patient may develop gangrene (dead bowel) and this may prove fatal if medical attention is not given immediately.
Different types of abdominal hernia
Inguinal hernia or groin hernia develops in the groin region due to the natural anatomical weakness present in that area. Hernia that develops in the internal ring within the groin area is called indirect inguinal hernia whereas hernia that develops near the groin area is called direct inguinal hernia. It is the most common type of abdominal-wall hernia that occurs mostly in men.
Femoral hernias appear in upper thigh region and these hernias are most common in women than men. Cause is usually the result of pregnancy and childbirth. Incidence rate is highest in middle-aged and elderly women, especially women who have had one or more pregnancies.
Umbilical hernia develops near the naval area. Most common in infants but can affect adults also. Medical attention is mandatory when hernia turns tender, discolored, swollen and/or when the infant seems to be suffering from abdominal pain.
Epigastric hernia occurs at upper abdominal area lying between the chest and naval. Develops in the middle of the upper abdomen between the breastbone and the umbilicus.
Spigelian hernia happens at the side of abdominal wall.
Incisional hernia develops at the place of incision that has occurred during earlier surgery. The place is a weak area usually an incompletely healed surgical wound. Symptoms are bulge or knot beneath the skin near the scar, sharp pains in the abdomen and/or constipation.
Causes of abdominal hernia
Abdominal hernia may be congenital (present at birth) or acquired later in life due to the weakening of abdominal muscles. Some other factors can also contribute to developing an abdominal hernia.
Symptoms and warning signs of abdominal hernia
Mild to intense pain and bulge on the abdomen or groin area are the significant indications of hernia. However, in few cases, patient may not experience any pain or may have only occasional pain and the swelling also may not appear. Almost all hernias swell up and enlarge with cough, continuous sneezing or any other condition that puts pressure on the abdomen. If the hernia involves intestines, patient will suffer from bowel obstruction and may have fever, nausea and vomiting.
Abdominal hernia treatment
Hernia is usually palpable and a surgeon can easily diagnose the condition during the clinical examination. Hernias are normally corrected through surgery as there is always a risk of strangulation associated with hernia. Reducible hernias are not a medical emergency; hence surgery appointments can be fixed according to the convenience of the patient and doctor. Irreducible hernias with painful lumps require immediate medical attention and surgery is performed as an emergency. During surgery the protruded organs are pushed back into the sack and if the intestines are strangulated, they will be removed. Sometimes, a synthetic mesh is placed behind the weakened abdominal muscle which will eventually merge with adjoining tissues and act as a protective wall against future recurrences.
Preventing Abdominal hernia
Some types of abdominal hernia cannot be prevented. Steps can be taken to avoid further complications and to prevent recurrence.
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Bibliography / Reference
Collection of Pages - Last revised Date: April 23, 2019