Hernia

A hernia is the protrusion of an organ or the fascia of an organ through the wall of the cavity that normally contains it. It occurs when an organ or fatty tissue squeezes through a weak spot in a surrounding muscle or connective tissue called fascia. The most common types are inguinal (inner groin), incisional (resulting from an incision), femoral (outer groin), umbilical (belly button), and hiatal (upper stomach).

Inguinal hernia: The intestine or the bladder protrudes through the abdominal wall or into the inguinal canal in the groin. About 80% of all hernias are inguinal.

Incisional hernia: The intestine pushes through the abdominal wall at the site of previous abdominal surgery. It is more common in elderly or overweight people who are inactive after abdominal surgery.

Femoral hernia: occurs when the intestine enters the canal carrying the femoral artery into the upper thigh. More common in women, especially those who are pregnant or obese.

Umbilical hernia: part of the small intestine passes through the abdominal wall near the navel. Common in newborns and women with many childbirths.

Hiatal hernia: happens when the upper stomach squeezes through the hiatus, an opening in the diaphragm through which the esophagus passes.

Symptoms:

Symptoms and signs vary depending on the type of hernia. Symptoms may or may not be present in some inguinal hernias. In the case of reducible hernias, a bulge in the groin or in another abdominal area can often be seen and felt. Besides the bulge, other symptoms include pain in the groin that may also include a heavy or dragging sensation, and in men, there is sometimes pain and swelling in the scrotum around the area.

Irreducible abdominal hernias or incarcerated hernias may be painful, but their most relevant symptom is that they cannot return to the abdominal cavity when pushed in. They may be chronic, although painless, and can lead to strangulation. Strangulated hernias are always painful and pain is followed by tenderness. Nausea, vomiting, or fever may occur in these cases due to bowel obstruction.

Causes:

Hernias are caused by a combination of pressure and an opening or weakness of muscle or fascia; the pressure pushes an organ or tissue through the opening or weak spot. Sometimes the muscle weakness is present at birth; more often, it occurs later in life. Poor nutrition, smoking, and overexertion all can weaken muscles and make hernias more likely. Anything that causes an increase in pressure in the abdomen can then cause a hernia, including obesity, lifting heavy objects, diarrhea or constipation, or persistent coughing or sneezing.

Treatment:

Hernia treatment will depend on the type of hernia you have. The most common hernia treatment is surgical repair (herniorrhaphy). Uncomplicated hernias are principally repaired by pushing back, or "reducing", the herniated tissue, and then mending the weakness in muscle tissue.

Muscle reinforcement techniques often involve synthetic materials (mesh prosthesis). The mesh is placed either over the defect (anterior repair) or under the defect (posterior repair).

Complications:

Complications may arise post-operation, including rejection of the mesh that is used to repair the hernia. A surgically treated hernia can lead to complications, while an untreated hernia may be complicated by:

Inflammation

Irreducibility

Obstruction of any lumen, such as bowel obstruction in intestinal hernias

Strangulation

Hydrocele of the hernial sac

Haemorrhage

Autoimmune problems

Incarceration