A hernia is the protrusion of an organ or the fascia of an organ through the wall of the cavity that normally contains it. A hernia occurs when the contents of a body cavity bulge out of the area where they are normally contained. These contents, usually portions of intestine or abdominal fatty tissue, are enclosed in the thin membrane that naturally lines the inside of the cavity. Although the term hernia can be used for bulges in other areas, it most often is used to describe hernias of the lower torso (abdominal-wall hernias). The bulging is usually more noticeable when the abdominal muscles are tightened, thereby increasing the pressure in the abdomen. Any activities that increase intra-abdominal pressure can worsen a hernia; examples of such activities are lifting, coughing, or even straining to have a bowel movement. Hernias by themselves may be asymptomatic (produce no symptoms), but nearly all have a potential risk of having their blood supply cut off (becoming strangulated). If the blood supply is cut off at the hernia opening in the abdominal wall, it becomes a medical and surgical emergency as the tissue needs oxygen which is transported by the blood supply.
The muscles and connective tissue of the abdominal wall are arranged in three separate layers. Before repairing any weakness, we gently place the fatty tissue and any part of the intestine (bowel) that may have bulged through the abdominal wall back inside the abdomen. Then we repair each muscle layer individually, using a technique that puts no tension on the natural tissue. By carefully overlapping and securing each layer, just like you do when you button a coat, we strengthen and reinforce this section of the abdominal wall.
This occurs in the groin region when either the fatty tissue(omentum) or the intestine push through the defect in the abdominal wall.
These types of hernias are most noticeable by their appearance. They cause bulges along the pubic or groin areas that can increase in size when you stand up or cough. This type of hernia may be painful or sensitive to the touch.
Inguinal Hernia May be Direct Inguinal Hernia or Indirect Inguinal Hernia
An indirect hernia follows the pathway that the testicles made during foetal development, descending from the abdomen into the scrotum. This pathway normally closes before birth but may remain a possible site for a hernia in later life. Sometimes the hernia sac may protrude into the scrotum. An indirect inguinal hernia may occur at any age.
The direct inguinal hernia occurs slightly to the inside of the site of the indirect hernia, in an area where the abdominal wall is naturally slightly thinner. It rarely will protrude into the scrotum. Unlike the indirect hernia, which can occur at any age, the direct hernia tends to occur in the middle-aged and elderly because their abdominal walls weaken as they age.
Occurring between the navel and the lower part of the rib cage in the midline of the abdomen, epigastric hernias are composed usually 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.
Abdominal surgery causes a flaw in the abdominal wall. This flaw can create an area of weakness in which a hernia may develop. This occurs after 2%-10% of all abdominal surgeries, although some people are more at risk. Even after surgical repair, incisional hernias may return. With the exception of internal hernias (within the abdomen), these hernias are commonly recognized as a lump or swelling and are often associated with pain or discomfort at the site. Internal hernias can be extremely difficult to diagnose until the intestine (bowel) has become trapped and obstructed because there is usually no external evidence of a lump.
During pregnancy, the umbilical cord passes through a small opening in the baby's abdominal muscles. The opening normally closes just after birth. If the muscles don't join together completely in the midline of the abdomen, this weakness in the abdominal wall may cause an umbilical hernia at birth or later in life. In adults, too much abdominal pressure can cause an umbilical hernia. Possible causes in adults which cause added stress on the abdominal wall and predispose to umbilical hernia include: