Overview:
- Is a defect in abdominal wall where a previous injury (surgery or trauma)
- it increases when coughing or doing intense muscle exercises
- Hernias are a common complication in abdominal surgery (10-15% of abdominal surgery can cause a incisional hernia)
Etiology:
- Protrusion of abdominal contents (peritoneal membrane, abdominal fat, intestine) through a defect in the abdominal wall muscles at the site of previous surgery
- cause of defect may be an incomplete closure of the previous wound, which leads to the survival of a small opening that grows over time by the influence of intra-abdominal pressure
- cause of defect may be a rupture of the muscle fibers (that have been sutured) after surgery, as occurs in chronic cough which leads to a defect in the abdominal wall through which the contents of the abdomen bulge
Symptoms:
- swelling at the place of the previous wound or around it increases when doing or coughing
- Discomfort in place of hernia
- An incarcerated inguinal hernia happens when tissue becomes stuck in the groin and isn’t reducible.
This means it can’t be pushed back into place.
- Strangulated inguinal hernias are a more serious medical condition.
This is when an intestine in an incarcerated hernia has its blood flow cut off
Symptoms of strangulated hernia:
- severe pain
- fever
- rough, swollen, reddish bulging
- nausea or vomiting
- inability to defecate or pass gases
(Visit emergency department immediately when these symptoms appear)
Causes:
Risk factors of incisional hernia are:
- Obesity
- Age: leading to muscle weakness
- Pregnancy
- ascites
- peritoneal dialysis
- Stressful physical activity
- connective tissue disease
Diagnosis:
- Careful clinical examination
- Ultrasound abdomen to confirm the diagnosis
- CT abdomen in rare cases
Treatment:
Surgery: laparoscopic surgical repair with mesh fixation
