What’s an Abdominal Hernia?
An abdominal hernia occurs when an organ or other piece of tissue protrudes through a weakening in one of the muscle walls that enclose the abdominal cavity.
The sac that bulges through the weak area may contain a piece of the intestine or fatty lining of the colon (omentum) if the hernia occurs in the abdominal wall or groin.
If the hernia happens through the diaphragm, the muscle that separates the chest from the abdomen, part of the stomach might be involved.
The abdominal wall consists of layers of various muscles and cells.
Weak spots can develop in these layers to permit contents of the thoracic cavity to protrude or herniate.
The most common abdominal hernias are in the groin (inguinal hernia), in the diaphragm (hiatal hernia), along the belly button (umbilical hernia).
Hernias may be present at birth (congenital), or they may develop anytime afterward (obtained ).
Which are the various types of Abdominal Hernias?
Different types of Hernias related to abdominal and pelvic floor:
Inguinal hernias: are the most comman.
The inguinal canal is an opening that allows the spermatic cord and testicle to descend from the abdomen to the scrotum as the embryo develops and matures.
Inguinal hernias are less likely to occur in girls since there’s no need for an opening in the inguinal canal to allow for the intrusion and descent of testicles.
A femoral hernia: may occur throughout the opening at the floor of the gut where there is space for the femoral artery and vein to pass in the abdomen into the top leg.
Due to their wider bone construction, femoral hernias tend to occur more often in girls.
Obturator hernias are the most typical hernias of the pelvic floor.
These are mostly found in women who’ve had multiple pregnancies or who have lost significant weight.
The hernia occurs through the obturator canal, another link of the thoracic cavity to the leg, and contains the obturator artery, vein, and nervewracking.
Hernias of the anterior wall of the Abdomen:
The abdominal wall consists of two sets of muscles on either side of the body that mirror each other.
They comprise the rectus abdominus muscles, the internal obliques, the external obliques, and the transversal.
When epigastric hernias occur in infants, they happen due to a weakness at the midline of the abdominal wall in which the two rectus muscles join together between the breastbone and belly button.
Occasionally this weakness doesn’t become evident until later in adult life because it appears as a bulge in the upper abdomen.
Pieces of bowel, fat, or omentum can become trapped in this kind of hernia.
The belly button, or umbilicus, is really where the umbilical cord attached the embryo to the mother allowing blood circulation to the fetus.
Umbilical hernias cause abnormal bulging from the stomach and are extremely common in newborns and frequently don’t require treatment unless complications occur.
Some umbilical hernias expand and might require repair later in life.
Spigelian hernias happen on the exterior edges of the rectus abdominus muscle and therefore are infrequent.
Incisional hernias occur as a complication of abdominal operation, in which the abdominal muscles are cut to permit the surgeon to go into the abdominal cavity to operate.
Diastasis recti isn’t a true hernia but instead a weakening of the veins in which both rectus abdominus muscles in the left and right come together.
The diastasis causes a bulge from the midline. It is different than an epigastric hernia because, the diastasis doesn’t trap bowel, fat, or other organs inside it.
Hernias of the Diaphragm:
Hiatal hernias happen when part of the stomach slides through the opening in the diaphragm where the esophagus passes from the chest into the stomach.
Paraesophageal hernias happen when just the stomach herniates into the chest alongside the esophagus.
This may lead to serious complications of obstruction or the stomach twisting upon itself (volvulus).
Traumatic diaphragmatic hernias may happen due to a major injury in which blunt trauma weakens or rips.
The diaphragm muscle, allowing immediate or delayed herniation of abdominal organs into the torso.
This may also happen after penetrating injury in the stab or gunshot wound.
Normally these hernias involve the diaphragm since the liver, located beneath the ideal diaphragm, tends to safeguard it from herniation of the bowel.
Congenital diaphragmatic hernias are infrequent and are caused by the failure of the diaphragm to completely close and form during embryonic growth.
This can result in failure of the lungs to fully grow, and it results in diminished lung functioning if abdominal organs migrate into the chest.
The most frequent type is a Bochdalek hernia at the side edge of the diaphragm.
Morgagni hernias are rarer and are a collapse of the front part of the diaphragm.
Causes an Abdominal Hernia:
A hernia could be present at birth or it may develop over time in areas of weakness inside the stomach wall.
Increasing the pressure within the gut can lead to stress at the weak points and permit elements of the gut cavity to protrude or herniate.
Increased pressure within the abdomen may occur in a variety of situations including
The increased fluid within the abdominal cavity (ascites),
Peritoneal dialysis used to treat kidney failure, and
The strain may raise due to lifting excess weight, straining to have a bowel movement or urinate, or from trauma to the gut.
Pregnancy or excess abdominal weight and girth are also factors that can lead to a hernia.
Risk factors for a Hernia:
Increased intra-abdominal pressure may result in the weakening of a portion of the gut wall, either gradually over time.
Persistent constipation
Chronic cough
Fat
Ascites (an abnormal collection of fluid from the abdominal cavity)
Abdominal masses
Repeatedly lifting or moving heavy objects
Signs and Symptoms of an Abdominal Hernia:
The majority of people can sense a bulge in which an inguinal hernia develops in the groin.
There may be a sharp or burning pain feeling in the area because of inflammation of the inguinal nerve or a complete feeling in the groin with action.
If a hernia happens due to an event like lifting a heavyweight, a sharp or tearing pain may be felt.
However, many folks do not have any complaints aside from a feeling of fullness in the area of the inguinal canal.
A parcel of bowel may go into the hernia and be stuck. If the gut swells, it can result in a surgical emergency because it loses its blood supply and becomes strangulated.
In this situation, there can be significant pain and nausea, and vomiting, signaling the possible growth of a bowel obstruction.
Fever may be connected with strangulated, dead gut.
A Richter’s hernia is an uncommon type of hernia that leads to strangulation.
Just 1 portion of the bowel wall becomes trapped in the hernia.
It won’t necessarily cause an entire bowel obstruction originally, because the passageway of the intestine still allows bowel contents to maneuver.
But that portion of the bowel wall that’s trapped can begin to swell, strangulate, and perish.
Femoral and obturator hernias within substantially the exact same manner as inguinal hernias, although because of their anatomic location, the fullness or lumps might be more difficult to appreciate.
Umbilical hernias are easy to enjoy and in adults often pop out with an increase in abdominal pressure.
The complications include incarceration and strangulation.
A hiatal hernia does not cause many symptoms by itself.
However, if a sliding hernia occurs, the abnormal location of the gastroesophageal (GE) junction above the diaphragm influences its function, and gut contents can reflux into the esophagus.
Gastroesophageal reflux (GERD) may cause burning chest pain, epigastric burning, and pain in the upper abdomen.
Nausea, vomiting, along with a sour flavor from stomach acid that washes into the rear of the throat.
It can involve any soft tissue, including muscle, tendon, or ligament, and can be initiated by bodily action, normally involving twisting or blunt force trauma to the abdomen.
What types of healthcare professionals treat and repair Hernias?
Most frequently, primary care providers will be the first to diagnose and treat a hernia.
For Hiatal hernias, generally medical, not surgical, maintenance is needed, and controlling the symptoms of GERD is the principal objective.
Some Hiatal hernias do need surgery and a general physician or a thoracic surgeon performs the operation.
It depends upon the location of these organs in the chest or stomach and the size of the defect in the diaphragm.
While primary care providers make the identification of an abdominal wall hernia, it is the general surgeon that performs the operation and also repairs the hernia.
How can health care professionals diagnose Abdominal Hernias?
For cerebral hernias, many patients notice a sense of fullness or a lump in the groin region with pain and burning.
Femoral or obturator hernias are more difficult to enjoy and symptoms of recurrent inguinal or pelvic pain without apparent physical findings might require a CT scan to show the diagnosis.
Umbilical hernias are easier to find using the bulging of the belly button.
The health care specialist seeks indications of obstruction, such as a history of pain, nausea, vomiting, or fever.
During a physical examination, a doctor may often find that a patient has a tender abdomen.
These hernias are usually exquisitely tender and firm.
The exam may be enough to suspect incarceration or strangulation and require immediate consultation with a physician.
Doctors can use X-rays or CT scans to verify the diagnosis, depending upon the clinical situation.
Physicians may be able to diagnose Hiatal hernias associated with GERD by learning a patient’s medical history through her or his physical examination.
A chest X-ray can show part of the gut within the torso.
If there is concern about complications including esophageal inflammation (esophagitis), ulcers, or bleeding, a gastroenterologist might have to do an endoscopy.
What types of operation to repair an Abdominal Hernia?
Inguinal hernia repair is one of the most common surgical procedures performed in the U.S. with almost a million surgeries occurring every year.
Surgery to repair a hernia can use a laparoscope or an open procedure called a herniorrhaphy, in which the surgeon directly fixes the hernia through an incision in the abdominal wall.
The kind of operation depends upon the clinical situation as well as the urgency of surgery.
The decision as to which operation to do depends upon the patient’s clinical situation.
However, doctors do not routinely provide operations because most symptoms are due to GERD and medical treatment is frequently sufficient.
Medication, diet, lifestyle changes, and weight loss may help control symptoms and decrease the need for surgery.
Non-surgical treatments for an Abdominal Hernia:
When an inguinal or umbilical hernia is modest and does not trigger symptoms, a watchful waiting strategy may be sensible.
But if the hernia does rise or when there is concern about potential incarceration, then surgery might be recommended.
Patients who are at high risk for surgery and anesthesia might be offered a wait and watch approach.
All these are temporary approaches and potentially can cause skin damage or breakdown, and infection because of rubbing and chafing.
They are often used in elderly or debilitated patients when the hernia defect is quite large and there’s a heightened chance of complications if they undergo surgery.
Unless the flaw is large, umbilical hernias in children often fix on their own by 1 year of age.
Surgery may be considered if the hernia remains current at age 3 or 4, or if the defect in the umbilicus is large.
Hiatal hernias by themselves don’t cause symptoms.
Instead, it’s the acid reflux that causes gastroesophageal reflux disease (GERD).
For more, please consult with this Gastroesophageal Reflux Disease (GERD).
Which are Hernia Complications?
The major complication of a hernia is incarceration, in which a parcel of gut or fat gets stuck in the hernia sac and can’t be reduced.
When a hiatal hernia is big, part of the stomach and esophagus can regrow into the chest.
Depending on the circumstance and anatomy, the stomach could spin (volvulus), possibly leading to strangulation. That is a surgical emergency.
What is the outlook for an Abdominal Hernia?
Incisional hernias may recur up to 10% of their time.
The prognosis for individuals who undergo emergent hernia repair because of the incarcerated or strangulated gut.
It depends upon the extent of the operation, just how much the intestine is ruined, and their inherent health and physical condition before the operation.
Because of this, elective hernia repair is much preferred.
Is it feasible to protect against an Abdominal Hernia?
While congenital hernias can’t be prevented, the risk of developing a hernia that occurs as life moves on can be minimized.
The goal is to avoid an increase in pressure in the gut that could stress the weak areas in the abdominal wall.
Eat a nutritious diet and exercise regularly to minimize the chance of constipation and straining to have a bowel movement.
Use proper lifting techniques especially when trying to lift heavy objects. It is important to consider in the office, home, and athletics.
Stop smoking to decrease recurrent coughing.
If a hernia develops, seek medical attention to get it assessed and potentially treated until it becomes too large or becomes incarcerated.
Ask your friends and loved ones for support.
If you’re feeling anxious or depressed, consider joining a support group or seeking counseling. Believe in your ability to take control of the pain…
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