Hernias are enlarged natural openings in the body or separations of muscle that allow underlying tissue to protrude through them. An example of a natural opening hernia is the hiatal hernia that allows a portion of the stomach to protrude into the chest cavity. Most hernias occur across the abdominal wall between the rib cage and the hips.
Causes of hernias are weaknesses in muscle present since birth, separation of muscle due to a previous incision, being overweight, pregnancy, chronic cough or chronic straining. The most common hernia is the inguinal hernia, and it is an example of a weakness in the muscle since birth. It is most common in men and usually presents as a lump or protrusion in either the left or right groin areas. The protrusions are usually associated with a dull ache or increased pain with heavy lifting. Other common hernias are umbilical, incisional and femoral.
If left untreated a hernia will gradually increase in size allowing internal organs such as the small or large intestines to protrude through the hernia and become more painful. Sometimes the muscle will trap the bowel within it. This is called an incarcerated hernia. Sometimes an incarcerated hernia could lead to a strangulated hernia where the blood supply to the bowel is cut off causing the bowel to become gangrenous. When this happens, an emergency operation is necessary to repair the hernia and remove the gangrenous bowel.
In most cases a hernia repair is an outpatient procedure. So, there is no need to spend the night in the hospital. The most common way to repair a hernia is with mesh. The mesh is a thin sheet of synthetic material fitted to overlap the hernia. Over the next 3 months the mesh becomes incorporated in the surrounding tissue making a strong repair and a decreased likelihood of the hernia recurring.
By Dr. Robert Ripley, General Surgeon, Board Certified – WCH
