Abdominal Hernia Introduction

Firstly, what is abdominal hernia? By definition, an abdominal hernia is a medical condition where an organ/tissue peeks via a weakened muscle wall that surrounds the abdominal cavity. The area that bulges through the weakened walls may have a piece of intestine or omentum if the condition is occurring in the abdominal wall or groin region. Alternately, if a hernia is found to be occurring through the diaphragm, a part of your stomach might be involved.

Most commonly, abdominal hernias would occur in the following areas:[1]

• Groin – the inguinal hernia
• Diaphragm – the hiatal hernia
• Belly button –the umbilicus

Now, let’s look at the different types of abdominal hernias here:

Types of Abdominal Hernias:

Hernias of Abdominal & Pelvic Floors:

• Inguinal hernias
• Femoral hernias
• Obturator hernias

Hernias of the Anterior Abdominal Wall:

• Epigastric hernias
• Umbilical hernias
• Spigelian hernias
• Incisional hernias
• Diastasis recti

Hernias of Diaphragm:

• Hiatal hernias
• Sliding hiatal hernia
• Paraesophageal hernias
• Traumatic diaphragmatic hernias
• Congenital diaphragmatic hernias

What are the Causes of Abdominal Hernias?

Hernias can be congenital, meaning to be present at birth, or it can develop during the later stages of life in the areas where the abdominal walls are weak. Whenever the pressure is increased within the abdominal cavity, the weaker points will be stressed, thereby making the parts of the abdominal cavity to bulge.[2]

Such an increase in pressure will occur inside the abdominal cavity under various situations. Examples include:

• A chronic cough
• A high amount of fluid within the abdominal cavity
• Peritoneal dialysis
• Tumors in the abdominal region
• Masses in the abdomen
• Heavy weightlifting
• Straining to urinate
• Stressing to have a bowel movement
• Trauma
• Pregnancy
• Excessive abdominal weight
• Girth

So, an individual with any of these following conditions is said to be at risk of contracting an abdominal hernia.

What are the Signs and Symptoms of Abdominal Hernia?

The signs and symptoms of different types of hernias are as follows:

Inguinal Hernias:

A majority of people with an abdominal hernia will feel a lump where the inguinal hernia develops. One can feel a burning/sharp pain in the region due to the inflammation of the inguinal nerve. Some people might have a feeling of fullness in the groin during activities. Hernia results due to activities like heavy weightlifting, a sharp or tearing pain will be felt.

Although there will be no complications, they could occur when a part of the intestine or omentum gets trapped in the sac of a hernia. In such cases, a part of bowel might go into the hernia and gets trapped. If this bowel becomes swollen, it can lead to a surgical emergency when the following symptoms can occur:[3]

• Severe pain
• Nausea
• Vomiting
• Fever

Richter's Hernia:

This is a rare type of hernia that will lead to strangulation.

Femoral and Obturator Hernias:

The symptoms of these types of hernias will be much more similar to  inguinal hernias. However, due to the location of these hernias, the lumps or fullness can be difficult to feel.

Umbilical Hernias:

These are difficult to feel in the adults as they tend to pop out with an increased abdominal pressure. Here, the complications will include incarceration, as well as strangulation.

Hiatal Hernias:

There are no symptoms for hiatal hernias. But, whenever a sliding hernia occurs, there will be gastroesophageal reflux due to the abnormal placement of gastroesophageal junction. This gastroesophageal reflux, will in-turn, leads various symptoms like:

• Burning chest pain
• Burning sensation in the upper abdomen
• Nausea
• Vomiting
• Epigastric pain
• A sour taste

Sports Hernia:

A sports hernia can be defined as the tear or strain of a tissue in the groin or lower abdominal region. As such, it leads to pain in the groin or inguinal region.

What are the Treatment Options Available for Abdominal Hernias?

If the inguinal or umbilical hernia is small in size and doesn’t have any symptoms, it’s good to wait. However, if you can find that your hernia is growing in size, you may need a routine follow-up. The best non-surgical approach to deal with an abdominal hernia involves using an Hernia Belt. This will help support the weakened abdominal muscles and is especially suitable for an umbilical hernia.

There are also other products like trusses, corsets, and abdominal binders to help hold hernias in place by applying pressure on the abdominal wall and skin. However, when the defect caused by a hernia is very large, surgery may be considered, especially if there is an increased risk of complications.

The surgery that is performed to repair a hernia may make use of laparoscopy or it may be performed as an open procedure called herniorrhaphy.

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References:

1..https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4605112/

2..http://www.cirurgiaunisa.com.br/assets/hernias-2.pdf

3..https://www.facs.org/~/media/files/education/patient%20ed/adultumbilical.ashx