What is Abdominal Wall Hernia?
Abdominal Wall hernia
is one of the leading abdominal disorders today. This condition is characterized by the the protrusion of the contents inside the abdomen through a weak spot in the abdominal wall. The inner layer of the abdominal wall is protected by a mucous lining. A tear in this lining can cause the abdominal organs to bulge out through it. This condition is more common among men than women. Men have a lifetime risk of 27% as compared to only 3% in women.
What are the Causes of Abdominal Wall Hernia?
Any perceptible pressure on the abdominal cavity may result in the disease. It may deteriorate any existing hernia making it necessary to fix it surgically. Some conditions which can increase the probability of the disease are as follows:
- Being overweight or obese.
- Excess strain in the abdomen while urinating or passing stools.
- Having a persistent cough which exerts a lot of pressure on the abdomen.
- Accumulation of fluid in the abdominal cavity.
- Chronic respiratory problems and lung disease.
Symptoms of Weakened Spots on the Abdominal Lining
- The condition may exist without symptoms for a long time.
- Bulges are predominantly found in the groin and can become more visible when pressure is exerted on the lower abdomen. It is also seen to bulge out while standing.
- Lying down may make it less apparent.
- When the the so called pouch exerts pressure on the intestines, it may become painful. It might happen while lifting heavy objects, standing up, straining during a bowel movement or when standing up. Otherwise, severe pain is not generally associated with it.
- The bulge can be reduced or may be gently forced back into the abdominal cavity. When this cannot be done, it usually indicates that a corrective surgery is imminent.
- In a more severe condition, when the abdominal organs like the intestines are forced through the hernia, they can remain lodged within it and cause an intestinal obstruction.
- The blood supply in the portion of the organ within the hernia may be reduced and can result in gangrene (destruction of tissues) and ischemia (reduced blood flow due to constriction of blood vessels).
Types of the Hernia
Indirect Inguinal hernia:
In men, the testicles descend into the scrotum through a spot in the abdominal wall which is already weak. It is called the internal ring. The abdominal organs can protrude through the internal ring and descend into the scrotum in men and in women in areas near the vagina. The weak spot in the abdominal wall can exist from birth or can develop later on in life.
Direct Inguinal hernia:
Mostly occurs in middle or old age. Aging or external injury are primarily known to cause it. In this case, the intestines bulge out near the internal ring but not through it into the scrotum.
- Maintaining a healthy weight.
- Reducing abdominal flab and girth.
- Eating high fiber foods and preventing constipation related strain.
- Avoid exerting pressure on the abdomen while coughing or lifting heavy objects.
- Surgical belts and trusses can give support to the abdomen and reduce the symptoms from any existing hernia.
1. Inguinal (Groin)Hernia:
This type attributes to 75% of the incidences of this condition. The abdominal contents protrude through the inguinal canal. It is the part of the body where the thighs meet the torso. It is seen 25 times more in men than women. However, there are two types of inguinal hernia.
2. Femoral Hernia:
This type is more often seen in women. The abdominal contents protrude through the femoral canal. This canal is meant for the passage of the femoral artery into the thigh. It is usually a constricted passage which can dilate to allow the intestines to bulge out through it abnormally in this condition. They are often irreducible and needs surgical intervention.
3. Umbilical Hernia:
Often noticed in newborns, it occurs when an opening in the abdominal wall does not close after birth. The weakened spot is where the umbilical cord gives way to the belly button. If the bulge is small, it generally corrects itself by the age of 2. However, larger hernias need to be surgically corrected between the ages of two and four. Even if the abdominal wall closes before birth, some individuals may carry a weakened spot throughout their life in that particular area which remains susceptible to hernia. Umbilical hernias are very often seen in women who have given birth or are pregnant because of the additional pressure in the abdominal region.
4. Incisional hernia:
This particular type appears through a weakened spot in the abdominal wall left behind after an abdominal surgery. 2-10% of abdominal surgeries result in such side effects. Even after surgical repair, the hernia may come back.
5. Epigastric hernia:
It can occur in any one between the ages of 20 and 50. It deals primarily with the bulging out of fatty tissue rather than any intestinal organ. It develops along the middle line of the abdomen between the navel and the lower rib cage. This particular type is difficult to be pushed back and requires surgical intervention.
6. Spigelian hernia:
It occurs rarely and the weak spot would develop along the edge of the rectus abdominus muscle. The abdominal contents would bulge out through the spigelian fascia in between the mid line and the side of the abdomen.
7. Obturator hernia:
It develops mostly in women and is extremely rare. The hernia advances from the pelvic cavity through the pelvic bone known as the Obturator Foramen. The bulge is not apparent making the condition difficult to be diagnosed. However, it is associated with symptoms of nausea and vomiting, and can also result in bowel obstruction.
Treatment of the disease
The disease is mostly treated with surgery to repair the hole or gap in the wall of the abdomen. Laproscopic surgery is done by making a small incision and repairing the hole by inserting special instruments through it. The recovery is much faster than in traditional surgery.