TEACH + LEARN

ABDOMINAL HERNIAS

What is a hernia?

The abdominal wall is made of fat, muscle, and skin that keep all of our organs inside. A hernia is a gap in the tough lining of the abdominal wall.

The red areas highlight “weak spots” in the abdominal wall where hernias are found commonly. The central circle is the belly button. The two lines between the leg and belly are the groin but are commonly referred to as inguinal hernias

Where can hernias appear?

  • Bellybutton (umbilical) hernias
  • Groin (inguinal) hernias

Who is more likely to develop a hernia?

  • Groin Hernia
    • Men and women can both develop hernias in the groin
    • Hernias in the groin are more common in men. During development the testicles pass through the groin to reach the scrotum. This passing through leaves a weak spot where a hernia can form in the future.

What are symptoms of a hernia?

Bowel has bulged through the hernia. It is not stuck and will wall back inside on its own
  • A bulge in the abdomen
    • This bulge is the hernia itself.
    • The hernia may worsen with standing, sitting or straining (anything that increases pressure inside the abdomen).
    • When the bulge stays out and is not painful it may be due to fat that has been trapped in the hernia and become stuck.

What increases my chance of developing a hernia?

  • Obesity
  • Pregnancy
  • Increased fluid inside the belly that pushes outward (sometimes seen with liver disease)
  • A scar from a previous surgery (scars are weak spots in the abdominal wall since the scar tissue isn’t as strong as normal tissue)

Will my hernia ever go away?

  • In children who have belly button hernias there is a chance that they may close over time.
  • In adults, hernias usually get bigger over time.
    • No different than skin that sags and becomes stretchy. as we age our tissues become weaker, thinner, the hernia or hole becomes larger.
When hernias become are stuck AND blood is unable to reach the bowel it becomes swollen and blocked. The skin overtop of the hernia becomes red and painful to touch. This is an emergency!

Why are some hernias fixed right away and other hernias fixed electively?

Hernia’s are fixed right away if the bowel is stuck in the hernia

  • Bowel (like a garden hose) is trapped and pinched in the hole. When bowel is stuck in a hernia the blood that keeps the bowel healthy is blocked and part of the bowel can die, called bowel gangrene.
  • When bowel is pinched the food flowing through it can also be blocked, this is called a bowel obstruction.

Hernia’s are scheduled or repaired electively if bowel is not stuck in the hernia

  • When there is simply a hernia where no bowel or fat is stuck your surgeon will schedule a time to fix the hernia as this is not an emergency

How are hernias fixed?

  • No Surgery
    • Without surgery a hernia cannot be fixed; however, not all hernias need to be fixed.
    • Some patients wish to simply “keep the bulge inside” and can do this by wearing a belt or support, called a truss.
  • Surgery
    • General surgeons have different techniques to fix hernias. These depend on the size, location, and a few other factors.
      • These techniques include include
        • Tissue Repair: Using your own tissues to close the hernia
        • Mesh Repair: When the hernia is larger than 1 cm your surgeon may decide to use mesh to reinforce the repair of the hernia. By reinforcing the repair your surgeon is trying to reduce the chances your hernia will come back.