The word hernia refers to the protrusion of any organ from the cavity that normally confines it. Most commonly hernia is used to describe the protrusion of the intestines through a defect or thinning of the abdominal wall. Certain areas of the abdominal wall become weaker than others over time and are weaker than other areas, thereby making that area more susceptible to developing a hernia.
A hernia develops when the intra-abdominal pressure increases such as with simple straining for bowel movements, lifting heavy items and with sneezing or coughing forcefully. When abdominal pressure increases a segment of the intestine moves through a weakened area of the abdominal muscle. The abdominal wall can be weakened, thinned or stretched from inadequate collagen and such a condition can be present since birth or develop over a period of time much as with normal aging or obesity.
Types of hernias are:
Inguinal – The inguinal ring is the point on the abdominal wall where the inguinal canal begins. Inguinal hernias are protrusion of the hernial sac, which contains the intestine at the inguinal opening. Direct refers to hernia extends out through the inguinal ring which follows the spermatic cord in men and the round ligament in women.
Indirect refers to hernia protrusion, which follows the posterior inguinal wall. This type often descends into the scrotum in men.
Umbilical – Umbilical hernias occur in the umbilical or belly button region, which the hernial sac protrudes. This type of hernia occurs in children when the umbilical orifice fails to close shortly after birth. It also may occur in obese adults who have prolonged abdominal distention.
Femoral – The femoral ring is at the abdominal opening of the femoral canal. Femoral hernias happen when the intestines descend through the femoral ring where the femoral artery passes into the femoral canal below the inguinal ligament. Strangulation to the artery is high with this type of hernia.
Incisional – Incisional hernias occur through the scar of a surgical incision when healing is impaired. Careful surgical technique, particularly in prevention of wound infection can prevent incisional hernias. Obese, old and malnourished patients are more prone to the development of incisional hernias.
When a hernia forms it tends to enlarge which can lead to more serious complications. Surgery is the only method of eliminating a hernia. Some patients because of inability to have surgery may choose to wear a truss, which is an apparatus that presses on the hernia and prevents the intestine protrusion. A patient may also lie supine and apply manual pressure over the protruding area to reduce the hernia periodically.
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