What is an abdominal hernia?
A hernia is a protrusion of tissue from one area of the body through the wall that contains it. The abdomen is a common place for hernias to occur. Hernias may be present at birth due to incomplete closure of a structure, or they may develop later due to increased abdominal pressure pushing against a weakened area of muscle or its fibrous sheath (fascia). Inguinal hernias, which occur more frequently in boys than girls, are the most common type of abdominal hernias.
Inguinal hernias and femoral hernias are both groin hernias, and they occur in the area between the lower abdomen and the thigh. Umbilical hernias occur directly beneath or near the navel. Hernias that occur where a surgery has taken place are called incisional hernias. Two other types of abdominal hernias, known as ventral and epigastric hernias, often occur in the middle of the abdomen, although ventral hernias can also occur in other locations in the abdomen.
Abdominal hernias typically include some of the membranous sac that encircles the abdominal organs (the peritoneum). They may also include fatty tissue and portions of the intestine. They may or may not be painful, and they are typically seen as a bulge in the abdomen, groin, labia or scrotum that increases in size over time. Most abdominal hernias are reducible as their contents can be pushed back into the abdomen, at least temporarily.
Surgery is typically required in the treatment of hernias to remove the portion of the peritoneum that is protruding through the opening, and to close and reinforce the opening. Occasionally, blood supply to the tissues protruding through the opening can be diminished, resulting in tissue “strangulation.” This is a medical emergency that requires immediate treatment to prevent tissue death. Tissue strangulation is typically accompanied by intense pain.
Intestinal strangulation is a potentially life-threatening medical emergency that requires immediate treatment to reduce the risk of bowel loss. Seek immediate medical care (call 911) if you, or someone you are with, have symptoms such as severe abdominal pain; increased swelling of a known hernia; a painful new bulge or mass; severe nausea and vomiting; inability to have bowel movements or pass gas; decreased or absent urine output; or high fever (higher than 101 degrees Fahrenheit).
Seek prompt medical care for bulges in the abdomen or groin, especially if they increase in size or become painful, or if you have been treated for an abdominal hernia but symptoms recur.
What are the symptoms of an abdominal hernia?
Some abdominal hernias occur without symptoms. A bulge may be noticed in the abdomen, groin, scrotum or labia. It may increase in size when abdominal pressure is increased, which occurs with coughing or heavy lifting. The area may be painful.
Common symptoms of abdominal hernia
Common symptoms of abdominal hernia include:
- Bulging area or lump in the belly or groin
- Enlargement of the lump with an increase in abdominal pressure
- Lump that is reducible with gentle pressure
- Painful lump
- Pain radiating down the leg
- Redness of the skin over a lump
- Swelling of the labia or scrotum
Serious symptoms that might indicate a life-threatening condition
Certain symptoms may indicate a life-threatening abdominal hernia. Seek immediate medical care (call 911) if you, or someone you are with, have any of these life-threatening symptoms including:
- Change in bowel habits, such as an inability to have bowel movements or pass gas
- High fever (higher than 101 degrees Fahrenheit)
- Increased swelling of a known hernia
- Not producing any urine, or an infant who does not produce the usual amount of wet diapers
- Painful new bulge or mass
- Severe abdominal pain
- Severe nausea and vomiting
What causes abdominal hernias?
Some abdominal hernias may be present at birth, and these are called congenital hernias. They generally result from incomplete or inadequate closure of part of the abdominal wall. You can also develop a hernia over time in weakened areas of the abdominal wall. These may not be noticeable at first, but as abdominal pressure continues to force tissues or intestines through the opening, a lump will be revealed under the skin.
There is a tendency for some types of hernias to run in families.
What are the risk factors for abdominal hernia?
A number of factors increase the risk of developing an abdominal hernia. Not all people with risk factors will develop an abdominal hernia. These risk factors include:
- Abdominal surgery
- Chronic constipation
- Chronic cough
- Enlargement of the prostate or other conditions that can lead to straining to urinate
- Family history of hernias
- Lifting or pushing heavy objects
- Male gender
- Nutritional deficiencies
- Undescended testes
Reducing your risk of abdominal hernia
There are steps you can take to reduce your risk of developing an abdominal hernia including:
How is an abdominal hernia treated?
Treatment of an abdominal hernia begins with a lifelong course of regular medical consultation and care. With regular visits, your health care provider is better able to screen for various conditions, and can more promptly evaluate symptoms and your risks for developing abdominal hernia.
The only cure for abdominal hernia is surgery, typically performed when your hernia has become uncomfortable or painful, or has increased in size. The surgical procedure involves pushing the protruding tissues and organs back into the abdominal cavity; removing the stretched, protruding portion of the peritoneum; and closing the peritoneal defect in the abdominal wall. Often, the site will be reinforced with mesh to reduce the risk of recurrence.
In some cases, surgery may not be necessary for small hernias as they can be monitored and mitigated with wearable “trusses” that help support the area of herniation.
What are the complications of abdominal hernia?
What are the potential complications of abdominal hernia? Failure to seek treatment for your abdominal hernia can result in serious, even life-threatening consequences. It is vitally important that you follow the treatment plan that you and your health care professional design specifically for you. Complications of abdominal hernia include:
- Bowel obstruction
- Intestinal strangulation
- Necrosis (death) of tissue and gangrene, which may require surgical removal of dead tissue
- Nerve damage
- Testicular injury