An abdominal hernia is due to a weakness in the muscular wall of the abdomen. Quite often this occurs through a point of natural weakness (as in an inguinal hernia or umbilical hernia), but may occur as a result of previous intervention, usually surgical (as in an incisional hernia or parastomal hernia). The weakness allows an aperture or defect to form in the muscle allowing the protrusion of a structure within the abdominal cavity. This is usually a portion of intra-peritoneal fat but it may be an organ, typically a section of bowel.
The typical symptoms, irrespective of the type and position of hernia, are discomfort and swelling exacerbated by exertion and relieved upon reclining. Most hernias are repaired to relieve the symptoms of swelling and discomfort but also to obviate the potential risk of strangulation. This is when in particular a portion of bowel that has protruded through the hernia defect becomes stuck (irreducible) and potentially cuts off its own blood supply resulting in death of the section of bowel (infarction). This necessitates urgent attention in the form of an exploratory operation and sometimes a resection of the dead segment of bowel.
Most hernias can be repaired laparoscopically (using key hole surgery) and the repair involves the replacement of an inner piece of polypropylene mesh which stays there forever. The patient continues their day to day activities, completely unaware of the presence of the mesh. With most hernias there is a recognised recurrence rate but this usually equates to no more than 2% over a five year period.
Hernias tend to be more common in males. The commonest hernia by far is an inguinal hernia. Femoral hernias are relatively rare but are considerably more common in females.
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