Types of Hernias and Surgical Treatments

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A hernia is a common medical condition that is easy to both diagnose and treat. Especially in today’s society thanks to the advancements in the field of surgery.

Hernias can be a painful occurrence for many people and the pain may worsen with movement, coughing, and even laughing.

There are several different types of hernias although three of them have significantly higher rates of incidence.

What is a Hernia?

A hernia is the protrusion of internal organs through a weak spot in the muscles and the connective tissue of the body. There are two ways Hernias can occur. The first is congenital which means that they are present at the time of birth. The second is developed during your lifetime.

There are several different types of hernia based on their location. However, there are four types that have a higher incidence rate than the others.

While hernias usually require immediate treatment to prevent nearly fatal health complications, congenital hernias often close by themselves around 5 years of age. This means that congenital hernias, which in most cases are umbilical hernias, do not require immediate medical treatment. In other words, you can manage it easily with regular follow-ups. Umbilical hernias affect approximately 10-20 percent of all newborns. Overall, they amount between 2 and 3 percent of all hernias.

The three most commonly occurring hernias are; inguinal hernia, femoral hernia, and umbilical hernia. Inguinal hernias, (depending on further sub-classifications), can be either congenital or acquired. Moreover, they are usually more likely to occur in males. Femoral hernias, on the other hand, are more common in females and umbilical hernias are congenital in origin.

Most Common Types of Hernia

As mentioned above there are three main types of Hernia based on incidence alone. However, there are many other types of hernia that can occur, in different age groups and genders. The causes and symptoms of most hernias are the same although there may be specific symptoms depending on the location and the effect the hernia has on its neighbouring structures.

1. Umbilical Hernia (Umbilicus)

This type of hernia includes protrusion of either fat in the abdominal cavity or intestines through the navel or the belly button. This hernia often presents as a bulge on the stomach, near the belly button. It amounts to almost 10 percent of all abdominal hernias. This type of hernia is not only a physical problem that can cause pain, but also an aesthetic issue that may cause problems for those suffering from it.

Congenitally, this issue arises from improper development of the abdominal wall and connective tissue, resulting in a hole or weakness of the wall.

In adults, this is the result of weakness in the abdominal wall through which the intestines protrude. As a result of excessive straining or physical activities.

2. Femoral Hernia (Thigh)

Femoral hernias are the result of muscles that protrude through a weakness in the groin region that appears as a lump near the inner thigh. These are the second most common hernia and usually present themselves in women of older age. Although the lump the hernia causes can be medium-sized, it is of extreme importance and requires early treatment. This treatment is necessary because the lump can begin to compress the neighbouring major arteries, femoral artery, and veins.

Due to the possible compromise in blood flow, it is recommended to undergo surgery for treatment of femoral hernia as soon as possible.

3. Inguinal Hernia (Groin)

This hernia type is the most common type of hernia. Like the above, it also causes a lump in the groin region.

It is the protrusion of fat or intestines through the lower stomach wall or inguinal ring. This type of hernia is more common in males, and has two further subtypes; direct inguinal hernia and indirect inguinal hernia. Apart from distinguishing between the subtypes, it can be difficult to separate inguinal hernias from femoral hernias. This is because they both appear as a bulge in the groin region.

Statistically, inguinal hernia affects 27 percent of men and roughly 3 percent of women, with most of the hernias occurring on the right side.

Inguinal hernia not only has intestines protruding through the weak spot but also reproductive organs in females.

In males, the protrusion of the organs does not only present as a lump but can often also present as testicular swelling.

4. Ventral Hernia (near Mons Pubis)

A Ventral Hernia (also known as an abdominal hernia) refers to a hernia that occurs at any point along the midline of the abdominal wall, when there is a defect, hole or weakness in the muscle. This weakness allows part of the intestine or abdominal tissue to push through the layer of muscle.

Less Common Types of hernia

1. Incisional hernia

This type of hernia is the result of bulging of internal organs and tissues from the wound of previous surgery or trauma, hence, the name incisional hernia. This hernia occurs due to improper healing of an incision after surgery, especially stomach surgery. It is also often referred to as a ventral hernia, although not all incisional hernias are ventral hernias. This is because ventral hernia refers to a hernia occurring along the midline of the stomach.

2. Sliding hernia

Sliding hernia or sliding hiatal hernia occurs due to sliding of the stomach through the hiatus or opening for the food pipe in the diaphragm, which separates the thoracic cavity with the lungs and the heart from the abdominal cavity with the gastrointestinal system. This type of hernia may either be present at the time of birth or may develop as you grow older.

3. Epigastric hernia

In this hernia type, fatty tissue bulges through a weak spot in between the belly button and the base of the breast bone or the sternum.

4. Spigelian hernia

This type of hernia is also known as a semilunar hernia because of its crescent shape. It occurs at the side of the abdomen, at the edge of the muscle that gets toned to produce six to eight packs. These hernias occur below the belly button or the navel.

5. Diaphragmatic hernia

As the name suggests, this type of hernia occurs through the openings in the diaphragm resulting in the movement of abdominal organs into the chest cavity or the thoracic cavity.

Causes of a Hernia

The cause of hernia always boils down to excessive pressure on an already weak muscle, that may either be present since birth or as a result of trauma later in life. Based on the type of hernia, the cause may change as well.

Umbilical hernias occur in the womb and can be the result of environmental toxins, maternal use of medications during pregnancy, and maternal infections. They can also occur in adults as a result of a difficult childbirth procedure that required strenuous pushing or in overweight people. Umbilical hernia can also occur as a result of prolonged, persistent coughing.

In general, hernias develop in adults as a result of straining as seen with constipation or haemorrhoids, frequent coughing, pregnancy, and obesity. Anything that can put pressure on the abdominal walls can result in a hernia in an adult.

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Symptoms of a Hernia

In most cases, hernias, regardless of the type, cause the same symptoms. The general symptoms of hernia include the following;

  • Swelling or bulge at the location of the hernia. This lump may disappear on laying down but coughing, straining in the toilet, laughter, or any sort of strenuous physical exercise can bring back the lump.
  • The bulge being painful
  • Lifting and bending cause pain
  • The size of the bulge increases over time
  • Dull aching sensation in the area of the hernia
  • Over time, the sensation of fullness in the lower abdomen may develop as a result of small bowel obstruction by the herniated organs.
  • And more.

Women and obese individuals may suffer from hidden symptoms as these populations are the least likely to develop full-blown hernia symptoms.

Treatment of Hernias

It is easy to diagnose Hernias with the help of physical examination and in rare cases, imaging modalities.

After diagnosis, your doctor will refer you to a surgeon as hernias usually require a surgical repair. Your surgeon, based on the type of hernia and your health, will then decide between either open surgery or laparoscopic surgery.

Open surgery refers to a wide incision being made through which the hernia repair is performed. Whereas laparoscopic surgery only requires the insertion of three thin laparoscopes into the abdominal cavity through small incisions.

Frequently Asked Questions about Types of Hernia

What is the most serious hernia?

  • Most hernia types are serious in presentation and require medical treatment.
  • Incisional hernias are considered to be more serious than other types. This is because they not only present with their own symptoms but also complicate the healing process of the procedure.
  • They also arise from improper wound healing and further the separation of the incision.

However, the most serious type of hernia is a strangulated hernia. This refers to the expulsion of the body organs through the opening, restricting blood flow, and can cause life-threatening situations. People who suffer from strangulated hernia need immediate medical intervention.

Which type of hernia is common in adults?

  • Hernia types differ not only based on age but also based on gender.
  • Generally, Inguinal hernias are the most common in adults with approximately one-third of all hernias being inguinal in origin.

What type of hernia is most common in females?

  • Females are less likely to suffer from a hernia than males. However, an inguinal hernia is more common in females than males.
    • It is the only type of hernia that has a predilection for the female gender.
  • Incisional hernias are a close second common type of hernia, mostly arising from the incisions made during the cesarean birth surgery.

What can be mistaken for a hernia?

  • Hernias often are underdiagnosed in females but at the same time, there are quite a few disorders that may be mistaken for a hernia.
  • A hernia may be misdiagnosed as one of the following problems;
    • Ovarian cyst
    • Endometriosis
    • Ectopic pregnancy
    • Fibroids
    • Adhesions from previous surgeries can also be mistaken for a hernia in women.
  • The vice versa is also very much true for these conditions.

Which type of hernia surgery is best?

  • The best type of surgical hernia repair depends on the hernia itself and it can differ vastly between types of hernia.
  • While abdominal hernia requires an open surgery for best results, inguinal hernia requires a laparoscopic approach to produce the best results.

What happens if a hernia is left untreated?

  • A hernia has no method of reducing naturally and requires medical intervention for proper management and pain relief.
  • If left untreated, hernias grow larger and can begin to compress neighboring structures. This can be life-threatening or at the very least, the cause of serious health complications.
  • If you have a hernia GET TREATMENT.

What are the signs of a hernia in a woman?

  • Hernia in women often presents as pelvic pain, that may exaggerate with pressure.
  • There is often a burning sensation and a bulge accompanying these symptoms. However, it is important to note that a hernia is a silent problem amongst women and timely diagnosis is often difficult.

Can belly fat hide a hernia?

  • Belly fat cannot hide a hernia but it can definitely cause one.
  • Obesity is one of the main risk factors of hernia that people can easily manage.
  • Being overweight or obese, however, has no effect on the symptoms or the treatment modality.

Does a hernia affect bowel movements?

  • Yes, hernias can cause bowel obstruction especially if arising from the small intestines.
  • Hernias, in men, can also extend into the scrotum causing pain and swelling.
  • This also affects the ability of men to urinate easily.
  • At the same time, people complain about straining with defecation while suffering from a hernia.

What does a hernia feel like to touch?

  • A hernia feels like a lump that may bulge more with certain maneuvers such as coughing, laughing, and such.

What is a floating hernia?

  • A floating hernia, more formally known as sliding hiatal hernia, is a type of hernia where the point of meeting between the food pipe and stomach moves through the diaphragm, from the abdominal cavity into the thoracic cavity, right by the lungs.
  • This movement can result in several medical conditions that have long-term complications.

Is hernia surgery considered major surgery?

  • Although the procedure is performed commonly, the procedure is still a major surgery.
  • It requires general anesthesia and often a hospital stay of up to two days.