Abdominal Hernia by Patricia Griffin Kellicker, BSN

En Español (Spanish Version)

Definition | Causes | Risk Factors | Symptoms | Diagnosis | Treatment | Prevention

Definition

The abdominal wall wraps around the center of the body. It extends from just below the rib cage to the pelvis. The wall keeps the intestines and other organs in the abdominal cavity. When the wall is weakened it can tear. Intestines or other organs can bulge through the opening. This is called an abdominal hernia. There are several types of abdominal hernias, all named for their location:

• Femoral hernias—develop in upper thigh area
• Inguinal hernias —develop in the groin area
• Abdominal wall defects—happen in the womb when the abdomen does not fully develop
• Umbilical hernia—develops near the belly button
• Epigastric hernia—develops in the upper abdominal wall (between belly button and chest)
• Spigelian hernia—rare and develops toward the side of the abdominal wall
• Diaphragmatic hernia —birth defect in the muscle between the chest and abdominal cavities
• Hiatal hernia —develops near the upper part of the stomach
• Incisional hernia—develops where there is an incision from surgery
• Ventral hernias—a type of incisional hernia that develops down the middle of the abdomen

Contact your doctor if you suspect you have a hernia.

Causes

Hernias may be acquired as an adult or present at birth.

There are also unknown reasons for this condition.

Risk Factors

These factors increase your chance of a hernia. Tell your doctor if you have any of these risk factors:

Risk factors for acquired hernias include:

• Male sex
• Infection to incision after surgery
• Activities that cause abdominal strain:
  • Heavy lifting
  • Coughing

• Conditions such as:
  • Pregnancy
  • Obesity
  • Asthma
  • Constipation
  • Chronic obstructive pulmonary disease

Risk factors for congenital hernias include:

• Family history

Symptoms

Most hernias are found because of a lump or bulge that sticks out. Sometimes a congenital hernia will be more obvious while a baby is crying. Often times there are no other symptoms.

Some people feel tenderness or discomfort where the hernia is located.

Diagnosis

Your doctor will ask about your symptoms and medical history. A physical exam will be done. The doctor will try to feel the hernia. You may be asked to cough or bend for the doctor to feel the hernia better. You may be referred to a surgeon to talk about removing the hernia.

Treatment

Most inguinal hernias enlarge over time. Large hernias can put pressure on surrounding tissues. This pressure causes pain.

Incarcerated hernia is the most serious complication of a hernia. It occurs when a loop of intestine becomes trapped in the abdominal wall. This in turn may lead to obstruction of the bowel. Strangulation can also occur if blood flow is slowed. A strangulated hernia is a medical emergency. It requires immediate surgery.

Talk with your doctor about the best plan for you or your child. Hernias can become bigger, infected, or stuck in one spot.

Surgery

Hernias are repaired with surgery. During the surgeries the bulging intestine is put back into place. The damaged wall is also repaired. In some cases a piece of mesh is inserted to provide extra support.

Your doctor may suggest laparoscopic surgery . This type of surgery repairs the hernia using a very small incision. The repairs are done using a lighted, thin tube and small surgical instruments.

Prevention

Congenital hernias cannot be prevented. To help reduce your chance of an acquired or adult abdominal hernia, take the following steps:

• Avoid becoming overweight.
• Avoid heavy lifting.
• Eat a high-fiber diet .
• Do not smoke (smoking can cause chronic cough).