At any given time, about 5% of the world’s population is affected by hernias. A hernia is a common condition that can affect a person at any age.
What is a Hernia?
A hernia is a lump that occurs when there is a weakness in the inside layers of the abdominal walls just under the skin. This causes the inner lining of the abdomen to push through the weakened area forming a balloon-like sac. This can result in a loop of the abdominal tissue or intestine slipping into the sac causing pain and other potentially serious health conditions.
A hernia can be around the belly button, near the groin, under the belly button, or just below the ribs. In most cases, a hernia tends to go back when pushed gently.
Causes of Abdominal Hernia
The exact cause of an abdominal hernia is unknown although it is thought to be a combination of muscle strain and weakness. The muscle weakness can be caused by a congenital defect such as the abdominal walls failing to close properly while in the womb, injury, damage from a previous surgery, chronic coughing, or aging.
There are also risks that contribute to the developing of a hernia such as straining due to heavy lifting, being pregnant, being constipated, undergoing a surgical procedure on the area, or gaining weight quickly.
Types of Hernias
There are two types of hernias: Regular and Complex Hernias.
Regular hernias are small common hernias such an umbilical or inguinal hernia. Regular hernias occur when there is a weak spot on the muscles surrounding the abdominal area. This can result in parts of tissues or organs bulging through the weak spot.
Hernias are not dangerous, but they do not go away on their own. For most cases of regular hernias, surgery is often needed to keep it from becoming painful or getting larger. This involves repairing the weakness or hole with a mesh material using laparoscopic techniques. For the regular hernias, the surgery is usually performed on an outpatient basis and the patient can go home after the procedure.
However, regular hernias can become complex hernias if repeated attempts to close them do not work.
A complex hernia occurs at the site of a prior hernia repair in which the hernia returns. There are often repeated attempts to repair the hernia and when they fail, the surrounding tissue may become stretched or weak and it may need to be replaced or augmented.
Causes of a Complex Hernia
A complex hernia can be caused by:
- Anemia (lack of enough red blood cells)
- Congenital defect
- Chronic obstructive pulmonary disease (COPD)
- Excessive abdominal pressure after surgery
- Multiple hernia surgeries
- Excessive corticosteroid use
- Poor hernia repair
- Wound infection
- Thinning or weakening of a previous surgical area.
Symptoms of a Complex Hernia
Symptoms of a complex hernia include:
- Abdominal pain
- Previous hernia repair
- Pain, redness, or hardness of the hernia
Diagnosis of a Complex Hernia
A complex hernia is diagnosed using the following tests:
- Ultrasound: This involves placing a sound imaging on the stomach to look at the structures of the pelvic organs and abdomen.
- Computerized tomography (CT): This involves drinking a contrasting liquid and the radiologist looking at the structure of the pelvic organs and abdomen on a CT scanner.
- Magnetic Resonance Imaging (MRI): This is used to detect small tears in the abdominal muscles.
Treatment of a Complex Hernia
A complex hernia can be difficult to treat due to past surgeries or complications such as infection, small bowel obstruction, or if the intestine becomes chocked or trapped.
It is also not unusual for a complex hernia to occur when another organ such as the ovaries, appendix, or spleen passes through the abdominal wall.
The aim of complex hernia repair surgery is to mend the damage to the said hernia, preventing the development of other hernias by strengthening the abdominal wall, improving the function of the abdominal wall, preventing intraabdominal organs from protruding, and providing an aesthetically appealing appearance.
The surgeons may need to rearrange the abdominal muscles during the procedure so as to close the hernia defect.
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