Hernias

Hernias are conditions that often cause abdominal and groin pain and can develop serious complications. The treatment is always surgical. Therefore, I will explain the ways to diagnose and control them until the patient can be evaluated and treated surgically.

A hernia is the protrusion of contents of the abdomen through a defect or weakness in the abdominal wall. It is caused by several factors, but the main ones have to do with the increase of intra-abdominal pressure from heavy loads, coughing a lot, and obesity, among others.

www.myupchar.com, CC BY-SA 4.0

a) How Do I Know if I Have a Hernia?

The first symptom of hernias is pain near an area of physiological or surgical weakness. This pain increases with efforts such as heavy lifting, coughing, or sneezing, and it gets better with rest. The abdominal weakness areas are the navel, the groin, the area above the navel, and any associated abdominal surgical scars.

b) Types of Hernia

The figure shows the most common locations of abdominal hernia. Any inflammation that is on or near a surgical scar is also susceptible to an incisional hernia.

Bruce Blaus, Own work, CC BY-SA 4.0

1. EPIGASTRIC HERNIA

The increase in volume or inflammation is observed above the navel. In thin people, the defect in the muscles can easily be seen. To improve the symptoms, an abdominal hernia support should be used.

PacoPeramo, Own work, CC BY-SA 3.0

2. UMBILICAL HERNIA

This is the most common type of abdominal hernia. It’s located exactly on the navel. It can become very painful and uncomfortable, especially when straining from bowel movements and coughing fits. When it is large (as in the figure), an umbilical hernia belt or abdominal hernia support can help with the pain.

Rocco_Cusari, CC BY-SA 2.5

3. INGUINAL HERNIA

This is located in the groin and is often seen in the elderly and in construction workers. It is the second most common type of hernia. It is painful and can extend as far as the scrotum. The way to improve symptoms is to use an inguinal hernia belt that supports the muscles and prevents the hernia from descending.

James Heilman, MD, Own work, CC BY-SA 3.0

4. FEMORAL HERNIA

This type of hernia is mostly seen in women in an area just below the groin, toward the thigh. It can be very painful and can extend to the labia major. It is not as common as the previous ones, but it is the main cause of pain in that area. The symptoms can improve by remaining at rest and avoiding heavy loads.

5. INCISIONAL HERNIA

Swelling can be seen over any operative scar in the abdomen. Its growth is progressive, and it can reach a large size. It is more common to see this type of hernia on surgical wounds that were difficult to heal or became infected or when there were several surgeries at the same incision. It is important to use an abdominal girdle if you notice an increase in volume over the scar and to avoid lifting heavy items.

Carlos Castillo, Own work

Anita Kurmann and Guido Beldi