A hernia occurs when abdominal tissue (a loop of intestine or omentum) bulges into or penetrates a weakened muscle area of the abdominal wall.
Types of hernias
Inguinal hernia
It is the most common type of hernia. It occurs when part of the abdominal contents (usually a piece of bowel) protrudes into the groin area.
Femoral hernia
It occurs approximately at the same region as the inguinal hernia just below the inguinal ligament. A loop of intestine protrudes though the passage ( femoral ring) that is normally used by large blood vessels as they pass between the abdomen and leg. It is more common in women
Umbilical hernia
It occurs when part of the bowel or fatty tissue pokes through an area near the belly button (navel, umbilicus), pushing through a weak spot in the surrounding abdominal wall.
Epigastric hernia
It appears as a bulge of the midline between the chest and the navel (the line connecting the right and left rectus abdominis muscle)
Incisional hernia
It is caused by an incompletely-healed surgical wound. It is the most common hernia after inguinal hernias.
Sports hernia
A sports hernia is a painful, soft tissue injury that occurs in the groin area. It most often occurs during sports (football, basketball) that require sudden changes of direction or intense twisting movements. It is caused by a strain or tear of any soft tissue (muscle, tendon, ligament) in the lower abdomen or groin area. There is not a visible bulge but pain occurs in the groin area that may radiate to the testicles and worsens with exercise or stretch.
Causes
- Genetic factors
- Any condition that increases the pressure of the abdominal cavity like
- Strenuous physical exercise
- Manual exercise combined with weight lifting
- Obesity
Normal evolution of hernias
The natural history of the hernias is unpredictable. They may remain the same in size for years without causing any symptoms but they never resolve on their own. In some individuals they may cause symptoms such as swelling, pain or burning.
Most hernias are reducible by manipulation with the fingers. When the content of a hernia become trapped into the sac the hernia is called irreducible. When the blood supply of an irreducible hernia cuts off, we have an emergency situation because the ischemia leads to fatal necrosis of the hernia’s content.
Treatment
The hernia repair requires surgery. The hernia content is repositioned into the abdomen and the deficit (hole) of the abdominal wall is closed by placing a mesh for reinforcement of the weak point. In many cases, especially in inguinal hernias, the operation can be done without general anesthesia, at an outpatient basis.