What is a ventral hernia?
A hernia is a protrusion of tissue from one area of the body through the wall that contains it. Hernias may be present at birth due to incomplete closure of a structure, or they may develop later as the result of increased pressure pushing against a weakened area of muscle or its fibrous sheath (fascia). Abdominal hernias are typically composed of a portion of the membranous sac that encircles the abdominal organs (the peritoneum), and they can also include fatty tissue and portions of the intestine.
Ventral hernias are a type of abdominal hernia that commonly occurs along the midline of the abdominal wall, although they can occur at any location on the abdominal wall. Umbilical hernias are those that occur beneath or near the navel. Ventral hernias that occur at the site of a previous abdominal surgery are called incisional hernias. They are fairly common.
You may experience pain with a ventral hernia, or have no pain at all. Typically, this type of abdominal hernia appears as a bulge in the abdomen that gets larger over time. Most ventral hernias are reducible, as their contents can be pushed back into the abdomen temporarily. Treatment requires surgery to reduce the contents of the hernia and to close and reinforce the opening in the abdominal wall.
If swelling is present, it can lead to entrapment, or “incarceration,” of the hernia contents. Incarceration can ultimately pose a risk of reduced blood supply to the tissues involved, resulting in tissue “strangulation.” Tissue strangulation is typically accompanied by intense pain, and it constitutes a medical emergency that requires immediate treatment to prevent tissue death (necrosis).
Tissue strangulation is a potentially life-threatening medical emergency requiring immediate medical intervention to reduce your risk of bowel or other tissue death. Seek immediate medical care (call 911) if you, or someone you are with, experience symptoms such as profuse sweating; severe abdominal pain; increased swelling with tight, glistening red skin; rapid heart rate (tachycardia); severe nausea and vomiting; change in bowel habits such as the inability to have bowel movements or pass gas; a decrease in or absence of urine output; or high fever (higher than 101 degrees Fahrenheit).
Seek prompt medical care if you develop a bulge in the abdomen, especially if it increases in size or becomes painful, or if you have been treated for a ventral hernia but symptoms recur.
What are the symptoms of a ventral hernia?
You may experience no symptoms with a ventral hernia, or you may notice a bulge in the abdominal wall. The bulge can expand under increased abdominal pressure, such as when you cough or push or lift a heavy object. The area may also be painful.
Common symptoms of a ventral hernia
Common symptoms of a ventral hernia include:
Abdominal lump that is painful
Abdominal lump that is reducible with gentle pressure
Bulging area or lump on the abdomen
Enlargement of the lump when abdominal pressure is increased
Redness of the skin over an abdominal lump
Serious symptoms that might indicate a life-threatening condition
Symptoms associated with a ventral hernia can be life threatening in some cases. Seek immediate medical care (call 911) if you, or someone you are with, have any of these life-threatening symptoms including:
An area of increasing swelling with tight, glistening red skin
Changes in bowel habits, such as an inability to have bowel movements or pass gas
High fever (higher than 101 degrees Fahrenheit)
Not producing any urine, or an infant who does not produce the usual amount of wet diapers
Severe abdominal pain
Severe nausea and vomiting
What causes a ventral hernia?
A ventral hernia may be present at birth (“congenital” hernia) or develop over time. Congenital hernias generally result from incomplete or inadequate closure of part of the abdominal wall. Most umbilical hernias are congenital. Ventral hernias that develop over time do so in weakened areas of the abdominal wall.
Some types of hernias are seen to run in families.
What are the risk factors for ventral hernias?
A number of factors increase your risk of developing a ventral hernia, but you may have one or more of these risk factors without developing a ventral hernia. Risk factors for ventral hernias include:
Enlargement of the prostate or other conditions that can lead to straining to urinate
Family history of hernias
Lifting or pushing heavy objects
Reducing your risk of ventral hernias
It may be possible to minimize your risk of ventral hernias by following a few basic preventive measures including:
Avoiding lifting or pushing heavy objects
Avoiding straining to urinate
Eating a healthy diet
Following recovery instructions and physical restrictions after surgery
Maintaining a healthy weight
Managing constipation and avoiding straining to have a bowel movement
How are ventral hernias treated?
Treatment of ventral hernias begins with regular medical consultation and care over the course of your life to ensure that your doctor has every opportunity to screen for various conditions, including risk of ventral hernias.
Once a ventral hernia has been diagnosed, the only cure is surgery, and surgery is typically performed once the hernia has increased in size or begun to cause discomfort. During the procedure, the protruding tissues and organs are pushed back into the abdominal cavity; the stretched portion of the peritoneum that protrudes is removed; and the peritoneal defect is closed. The opening in the abdominal wall is then closed and may also be reinforced with mesh to reduce the risk of recurrence.
What are the potential complications of ventral hernias?
Failing to seek treatment promptly if you suspect you have a ventral hernia can result in serious, even life-threatening complications. You can take an active role in minimizing the risk of serious complications by carefully following the treatment plan that you and your doctor design specifically for you. Complications of untreated ventral hernias include:
Necrosis (death) of tissues and gangrene, which may require surgical removal of the dead tissues