Ventral/Incisional Hernia

February 27, 2020 at 11:17 am

A hernia is the condition in which an organ is displaced through the wall of a cavity containing it, thus an abdominal hernia is projection of any intra-abdominal structure through the abdominal wall. This can be caused from a congenital defect, weakness of the abdominal muscles, and at surgery sites that violate the abdominal wall.

The most common places for hernias to occur are at prior surgical scars (incisional), at natural orifices (umbilical), or on a patient’s midline (ventral). Anything that increases the intra-abdominal pressure (coughing, straining with heavy lifting, ascites, obesity, etc.) contributes to the development of a hernia, especially in those with developmental abnormalities, pregnant patients, or patients who have had surgery before.

Hernias usually present as a reducible bulge, which can be bothersome cosmetically and occasionally cause symptoms such as nausea, vomiting, constipation, and pain at the hernia site. In some individuals no obvious bulge is appreciated—but symptoms are present—and imaging such as a computed tomography (CT) scan is used to make the diagnosis. When herniated contents become entrapped and cannot be pushed back into the abdomen, this is called incarceration. This can cause a compromise of the hernia contents and is a surgical emergency.

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