Hernias are a fairly common occurrence and are most common in the abdomen area. A hernia occurs when an organ pushes through tissue or muscles that would typically hold that organ in place. Although hernias are not typically life threatening, the complications of hernias can be and treatment should be sought for addressing this.
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Below are the most common types of hernias together with a brief explanation of the type and occurrence of hernia:
The most common type of hernia is the inguinal hernia, which occurs in the wall of the abdomen. It is typically more common in males than females, due to the fact that a male has the internal inguinal ring, which develops from the inguinal canal, where a male's testicles descend from before birth. If this does not seal properly, there is a natural defect that puts the male at a disadvantage when it comes to the development of these types of hernias. Organs in the abdomen, such as the intestines may protrude into and through the opening, and this results in a bulge, typical of the inguinal hernia, whilst often times resulting in pain too.
Repair of an inguinal hernia through tension repair have a reported high recurrence rate, whilst other repair techniques have reported lower recurrence rates.
Umbilical hernias occur near the bellybutton or navel, which has a natural weakness from the blood vessels of the umbilical cord. These hernias may occur in infants at or just after birth and may resolve by three or four years of age. However, the area of weakness can persist throughout life and can occur in men, women, and children at any time. In adults, umbilical hernias will not resolve and may progressively worsen over time. They are sometimes caused by abdominal pressure due to being overweight, excessive coughing, or pregnancy. When repaired with a technique called tension repair, umbilical hernias have an 11% recurrence rate.3 Other hernia repair techniques, such as tension-free and laparoscopic tension-free, have much lower recurrence rates. See Methods of Repair for more information.
A strangulated hernia is also referred to as an incarcerated hernia. This occurs when the hernia has become trapped in or outside of the abdominal wall, and as a result cannot be 'pushed' back in. When a hernia becomes strangulated the blood to the tissue can be cut off and this can become life-threatening if it isn't treated in a timely manner.
The strangulated hernia is often most related to the Inguinal hernia, and develops when it becomes strangulated or incarcerated.
Symptoms of strangulated hernias include sharp and intense pains, vomiting, nausea, a dark red or purple hernia bulge and fever, amongst others.
The causes of hernias are varied, and lifestyle can be a contributing factor. It is always recommend to consult your physician should you notice a bulge developing, and which is often best noticed when standing.
A hernia that appears in the abdomen at the site of a previous surgery is known as a ventral or incisional hernia. These hernias can appear weeks, months, or even years after surgery and can vary in size from small to very large and complex. If you think you have a ventral hernia, it's important to see your doctor because it may widen and become extremely difficult to repair. When repaired with a technique called tension repair, ventral hernias have a 50% recurrence rate.2 Other hernia repair techniques, such as tension-free and laparoscopic tension-free, have much lower recurrence rates. See Methods of Repair for more information.
Femoral hernias, along with inguinal hernias are groin hernias. They are much more common in women but can occur in men. These hernias appear just below the groin crease and are usually the result of pregnancy and childbirth. A weakness in the lower groin allows an intestinal sac to drop into the femoral canal, a space near the femoral vein that carries blood from the leg. These hernias are more prone than inguinal hernias to develop incarceration or strangulation as an early complication. Therefore, once these hernias are diagnosed, early repair is very strongly advised before such complications occur.
Epigastric hernias are more common in men than in women. They occur due to a weakness, gap, or opening in the muscles or tendons of the upper abdominal wall, on a line between the breast bone and the navel or umbilicus. This area is known as the epigastrium area of the abdomen, and hence the name for the hernia.
Hiatal hernias are slightly different from other types of hernias because they are a weakness or opening in the diaphragm, which is the muscle that separates the chest cavity from the abdominal cavity. These hernias cause reflux of acid from the stomach into the esophagus, which can lead to heartburn, pain, and erosion of the esophagus. Surgery to repair this type of hernia is usually more complicated and may require a longer hospital stay.
Hernias can be treated with the "watch and wait" (non-surgical) option or the surgical option, the latter there are two main approaches within which the surgeon may opt for using surgical mesh, or by stitching the tissue in an attempt to resolve problem. Unfortunately stitching the tissue option does show a relatively high recurrence rate and thereby increasing the 'popularity' of the surgical mesh option.
Watching, waiting and monitoring a hernia is perhaps excluded when there is an amount of pain associated to the hernia. This option also requires that specific lifestyle changes be made, particularly in the case of hiatal hernias. And specific recommendations include dietary considerations, avoidance of large and/or heavy meals as well as avoiding laying down after meals. Although medication may offer respite from the discomfort associated with hiatal hernias it is often times recommended to seek out the underlying causes, and to deal with them effectively.
The repair of hernias by means of surgery will normally follow one of two main options, being that of stitching tissue together to seal the opening where the hernia is occurring, or with the implant of surgical mesh, together with the stitching of tissue. The surgical mesh is there to support the surrounding tissue and can be manufactured from either absorbable or non-absorbable materials.