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Tulane On Call Video

Hernia Video

Hernia question and answer session with Dr. Jim Korndorffer

 

Types of Hernias

The term “hernia” refers to a condition when an internal part of the body protrudes through an opening into an area where it doesn’t belong. Hernias are characterized by their location in the body and occasionally by their specific cause. They can occur in men and women of all ages, and in children as well.

 

Inguinal Hernia

bi-lateral inguinal herniaAn inguinal hernia occurs when the inside layers of the abdominal muscle have weakened, resulting in a bulge or tear in the surrounding muscle or connective tissue. This can result in the inner lining of the abdomen pushing through the weakened area of the abdominal wall or into the inguinal canal in the groin, possibly causing severe pain and potentially serious problems. Approximately 80% of all hernias are inguinal and most occur in men due to a natural weakness in this area.

 

Umbilical (bellybutton) Hernia

umbilical herniaUmbilical hernias are a common hernia that often present in babies at birth as a lump at the bellybutton (the umbilicus). This hernia is caused when an opening in the abdominal wall, which normally closes before birth, doesn't completely heal. If the opening is small (less than half an inch) this type of hernia will usually close by itself by the time the child reaches 2 years of age. Larger hernias generally do not close by themselves and usually require surgery when the child is between 2 and 4 years of age. Even in cases when the area of weakness closes by birth an umbilical hernia can still appear later in life because this spot remains a weak point in the abdominal wall. Umbilical hernias can also appear in elderly people and middle-aged women who have had children, particularly among women who are considered to be overweight.

Ventral Hernia Repair

 

Incisional (Ventral) Hernia

The incision that is required to perform abdominal surgery creates an area of weakness in the abdominal wall; occasionally this can result in a hernia, months or years after the procedure. An open surgical procedure that required a large incision in the abdominal wall is more likely to result in an incisional hernia than a procedure that was performed using a minimally invasive surgical technique.

 

Sports-Related Hernia

Sports hernias occur due to sports related stresses, exertion or injuries when muscles in the lower abdomen tear, resulting in discomfort in the lower abdomen and groin area. Sports hernias are most often occur in men and are related to the thickness, not the strength, of the abdominal wall. Sports hernias do not present a bulge in the skin and are often confused with groin strains.

 

Epigastric Hernia

Occurring between the navel and the lower part of the rib cage in the midline of the abdomen, epigastric hernias are usually composed of fatty tissue and rarely contain intestine. Formed in an area of relative weakness of the abdominal wall, these hernias are often painless and unable to be pushed back into the abdomen when first discovered. This type of hernia occurs mainly in men and generally in people 20-50 years of age.

 

Hiatal Hernia

Hiatal hernias occur when the upper stomach protrudes through the hiatus, an opening in the diaphragm through which the esophagus passes. In most cases a small hiatal hernia won’t cause problems and may not be noticed unless your physician finds it while checking for a different condition. A large hiatal hernia may require surgery if it is of the size that allows food and stomach acid to back up into the esophagus.

 

Femoral Hernia

The femoral canal is where the femoral artery, vein, and nerve leave the abdominal cavity to enter the thigh. Although normally a tight space, it sometimes becomes large enough to allow abdominal contents (usually intestine) to be pushed into the canal. A femoral hernia causes a bulge below the inguinal crease in roughly the middle of the thigh. Rare and usually occurring in women, femoral hernias are particularly at risk of becoming irreducible (can't push it back in) and strangulated (tissue becomes trapped). They are always repaired due to the high risk of limiting the blood supply to the intestine or hernia sac.

 

Spigelian Hernia

This rare hernia occurs along the edge of the rectus abdominus muscle, several inches to the side of the middle of the abdomen, and can be difficult to diagnose.

 

Obturator Hernia

An obturator hernia is a relatively rare abdominal hernia that occurs mostly in women. This hernia protrudes from the pelvic cavity through an opening in the pelvic bone (obturator foramen). No bulge appears, but the hernia can act like a bowel obstruction and cause distress, nausea and vomiting. As there is no bulge, and the pain can often be diffuse, this can be a difficult hernia to diagnose.

 

Flank Hernia

Flank hernias most often occur as a result of an injury to the side of the abdominal wall or after a surgical event on the kidneys, although they can appear without injury or surgery. Historically this was a difficult hernia to repair but with the advent of new surgical materials and techniques success rates have improved significantly.

Tulane Hernia Center, New Orleans, LA 70118 504-988-5110 surgery@tulane.edu