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What is an Abdominal Wall Hernia?

September 05, 2019 | General Surgery | Medical Arts Building - Clearfield


Abdominal wall hernias are commonly seen by general surgeons. The abdominal wall is made up of muscles and the tissues, which attach the muscles together or attach the muscles to bone. In areas where there is a weakness or natural opening in the abdominal wall, the abdomen’s internal contents can push through, and that is what is called a hernia. The abdominal contents (frequently fat or bowels) can push through the abdominal wall and then fall back inside the abdomen (reducible hernia) or sometimes they can get stuck (incarcerated hernia).

What are some common types of abdominal wall hernias?

The umbilical cord was once attached to the umbilicus (a.k.a. the belly button). This creates an area of weakness, and hernias in this area are called umbilical hernias. 

There are also several types of groin hernias. Inguinal hernias occur in the groin where the inguinal canal is located, near the pubic bone. There is an area of the groin where blood vessels travel from the abdomen to the leg, and hernias in this location are called femoral hernias. 

Sites of prior surgery on the abdominal wall have scar tissue which is weaker than the healthy muscles around it, and hernias through this scar tissue are called incisional hernias. 

How do I know if I have a hernia?

Hernias are frequently visible as a bulge in the abdominal wall. The hernia may or may not cause discomfort or pain at the site. Sometimes hernias can enlarge over time. Other hernias, which were not painful in the past, can suddenly become painful. Sometimes activities which cause tightening of the abdominal wall, such as heavy lifting, coughing or straining with bowel movements, can make the hernia get larger or hurt. 

Can I prevent a hernia?

Maintaining a healthy body weight, avoiding heavy lifting and not straining to urinate or pass stool helps prevent a hernia from developing. You can also exercise regularly to strengthen your abdominal wall muscles. If you already have a hernia it will not go away, but it may improve with weight loss down to a healthy weight.

When should I see a doctor?

Small, non-painful hernias which are not enlarging can be mentioned to your primary care physician at your next wellness exam. 

Hernias which are mildly painful or enlarging should be evaluated by a surgeon to see if your hernia should be repaired. 

Hernias which are severely painful may be a sign that the abdominal contents in the hernia have twisted and are dying due to the obstructed the blood supply. This is an emergency and requires immediate treatment. 

How is a hernia diagnosed?

Many hernias can be diagnosed based on talking to the patient and performing a physical exam. Sometimes CT (computed tomography) scans or ultrasound are used to visualize the hernia for diagnosis or surgical planning.

How is a hernia repaired?

The goal of hernia surgery is to remove any trapped abdominal contents from the hernia, to place those structures back into the abdomen and then to close the abdominal wall hernia opening. Each hernia needs to be individually evaluated to determine the best approach.

Some small, non-painful hernias may be watched for the development of symptoms. Most non-emergency hernias which do require surgery can be repaired as an outpatient, where the patient is sent home after surgery.
 
Some hernias may best be repaired with a single larger incision (open surgery) or multiple smaller incisions (laparoscopic surgery). Many hernias are repaired by implanting a piece of synthetic mesh at the site of the hernia, which provides added strength to the abdominal wall and helps prevent the hernia from returning. 

What can I expect after hernia surgery?

Postoperative pain at the hernia and incision sites should be tolerable with prescription pain medication. Also, bruising and swelling are commonly experienced after surgery.  Most people with sedentary jobs can return to work in 7-10 days and patients will be instructed to avoid heavy lifting or strenuous activity for at least 6-8 weeks. Hernia surgery is usually safe and effective, but there are always risks to pursuing any surgical procedure. Always discuss the benefits, risks and alternatives to surgery with your doctor.

How do I find a hernia doctor?

Penn Highlands Healthcare has many general surgeons who can repair these types of hernias. Most patients can visit their primary care provider to obtain a diagnosis and specialist referral to a nearby general surgeon. If you do not have a primary care physician, go to www.phhealthcare.org/findadoc to find a Penn Highlands provider in your area.

Note: To contact Dr. Lisa Coughlin’s office in the Medical Arts Building in Clearfield, call 814-205-1900.