A hernia is usually a sac formed by the lining of the abdominal cavity (peritoneum). The sac comes through a hole or weak area in the fascia, the strong layer of the abdominal wall that surrounds the muscle.
The types of hernias are based on where they occur:
Hernia - inguinal; Inguinal hernia; Rupture; Strangulation; Incarceration
Usually, there is no obvious cause of a hernia. Sometimes hernias occur with heavy lifting. Hernias may be present at birth, but the bulging may not be noticeable until later in life. Some patients may have a family history of hernias.
Hernias can be seen in infants and children. This can happen when the lining around the abdominal organs does not close properly before birth. About 5 out of 100 children have inguinal hernias (more boys than girls). Some children may not have symptoms until they are adults.
Any activity or medical problem that increases pressure on the abdominal wall tissue and muscles may lead to a hernia, including:
Most often there are no symptoms. However, sometimes there may be discomfort or pain. The discomfort may be worse when you stand, strain, or lift heavy objects.
Although a hernia may only cause mild discomfort, it may get bigger and strangulate. This means that the tissue is stuck inside the hole and its blood supply has been cut off. If this occurs, you will need urgent surgery.
A doctor can confirm the presence of a hernia during a physical exam. The mass may increase in size when coughing, bending, lifting, or straining.
The hernia (bulge) may not be obvious in infants and children, except when the child is crying or coughing. In some cases, an ultrasound may be needed to look for a hernia.
Surgery is the only treatment that can permanently fix a hernia. However, smaller hernias with no symptoms can sometimes be watched. Surgery may have more risk for patients with serious medical problems.
Surgery will usually be used for hernias that are getting larger or are painful. Surgery secures the weakened abdominal wall tissue (fascia) and will close any holes. Today, most hernias are closed with cloth patches to plug up the holes.
An umbilical hernia that fails to heal on its own by the time your child is 5 years old may be repaired.
Emergency surgery is sometimes needed. The sac containing the intestine or other tissue may become stuck in the hole in the abdominal wall. If it cannot be pushed back through, this can lead to a strangulated loop of intestine. If left untreated, this portion of the intestine dies because it loses its blood supply.
Instead of open surgery, some hernias can be repaired using a laparoscope (camera). The advantages of using a camera include small surgical cuts, faster recovery, and less pain after the procedure.
For information on hernia surgery, see also:
The outcome is usually good with treatment. Recurrence is rare (1-3%).
In rare cases, inguinal hernia repair can damage structures involved in the function of a man's testicles.
Another risk of hernia surgery is nerve damage, which can lead to numbness in the groin area.
The biggest risk of hernia surgery is another hernia, which may occur years later.
Call your doctor right away if:
Call your doctor if:
Turnage RH, Richardson KA, Li BD, McDonald JC. Abdominal wall, umbilicus, peritoneum, mesenteries, omentum, and retroperitoneum. In: Townsend CM, Beauchamp RD, Evers BM, Mattox KL, eds. Sabiston Textbook of Surgery. 18th ed. Philadelphia, Pa: Saunders Elsevier;2008:chap 43.