A hernia occurs when part of an internal organ or body part protrudes through an opening into another area where it ordinarily should not be located.

A hernia usually develops between your chest and hips. In many cases, it causes no or very few symptoms, although you may notice a swelling or lump in your tummy (abdomen) or groin.

Types of hernia

Hernias occur in various locations. Some hernias are present at birth, while others develop during adulthood. Hernias may enlarge due to increased pressure inside the abdomen, such as during straining, persistent coughing, obesity, or pregnancy.

  1. Inguinal Hernia

Inguinal hernias occur when fatty tissue or a part of your bowel pokes through into your groin at the top of your inner thigh. Inguinal hernias account for 75% of all hernias and are five times more common in males than females. They may be present in infants but can develop in adults also.

2. Femoral hernia 

This is a hernia through the passage that contains the large blood vessels (the femoral artery and vein) between the abdomen and the thigh. This type of hernia causes a bulge in the upper thigh just under the groin and is more common in women than men.

3. Umbilical hernia

Umbilical hernias occur when fatty tissue or part of your bowel pokes through your tummy near your belly button. This type of hernia can occur in babies if the opening in the tummy that the umbilical cord passes through does not seal properly after birth.

4. Epigastric hernia 

A small bit of fat bulges through a weakness in the upper abdominal muscles between the navel and breastbone. Most people with such hernias are between ages 20 and 50. These hernias are often so small that they may go unnoticed.

5. Incisional hernia 

Intestine bulges through a weakness in the abdominal wall in an area where there has been previous surgery. The skin has healed, but the underlying muscle has pulled apart, resulting in a hernia. These hernias can be small or quite large.

6. Hiatus hernia 

This hernia involves the stomach rather than the intestine. The stomach slips upward through the normal opening in the diaphragm and passes into the chest. It is often associated with acid reflux, or “gastroesophageal reflux disease” (GERD), which causes heartburn.

Symptoms

Most hernias cause a bulge under the skin (except hiatus hernias). The location of this bulge depends on the specific type of hernia. For example, an inguinal hernia appears as a bulge in the groin, while an umbilical hernia appears as a bulge near the navel. Some hernias can cause twinges of pain or a pulling sensation, but most do not cause pain. Hernias are usually easier to see with coughing or straining. They also tend to be more prominent with standing and often disappear with lying down.

Diagnosis

Most people discover their own hernias by noticing a bulge. Sometimes, however, your doctor will find a small hernia as part of a routine examination. Your doctor makes the diagnosis by physical examination. He or she may ask you to strain or cough (especially while standing), which may make the bulge easier to see or feel.

Rarely, you may have symptoms that suggest a hernia, but the doctor will be unable to find one at the time of examination. In these circumstances, your doctor may recommend a computer tomography (CT) scan or an ultrasound of the abdomen.

When to seek medical advice

You should go to your nearest emergency straight away if you have a hernia and you develop any of the following symptoms:

  • sudden, severe pain
  • being sick
  • difficulty pooing or passing wind
  • the hernia becomes firm or tender, or cannot be pushed back in

These symptoms could mean that either: 

  • the blood supply to a section of organ or tissue trapped in the hernia has become cut off (strangulation)
  • a piece of bowel has entered the hernia and become blocked (obstruction)

A strangulated hernia and obstructed bowel are medical emergencies and need to be treated as soon as possible.

Treatment

Once a diagnosis has been confirmed, the doctor will determine whether surgery to repair the hernia is necessary.

A number of factors will be considered when deciding whether surgery is appropriate, including:

  • The type of hernia – some types of hernia are more likely to become strangulated or cause a bowel obstruction than others
  • The content of your hernia – if the hernia contains a part of your bowel, muscle or other tissue, there may be a risk of strangulation or obstruction
  • Your symptoms and the impact on your daily life – surgery may be recommended if your symptoms are severe or getting worse, or if the hernia is affecting your ability to carry out your normal activities
  • Your general health – surgery may be too much of a risk if your general health is poor.

There are 2 main ways surgery for hernias can be carried out:

  • Open surgery – where a cut is made to allow the surgeon to push the lump back into the tummy
  • keyhole (laparoscopic) surgery – this is a less invasive, but more difficult, technique where several smaller cuts are made, allowing the surgeon to use various special instruments to repair the hernia

Should you require additional information or would like to make an appointment with our Consultant , Dr. Majid Bassuni,  please call us or e-mail us at info@tawamhospital.com

Disclaimer: All contents on this site are for general information and in no circumstances information be substituted for professional advice from the relevant healthcare professional, Writer does not take responsibility of any damage done by the misuse or use of the information.

Reference:

  • American College of Surgeons (ACS)
  • NHS.uk
  • health.harvard.edu