Definition: Defining the Meaning of Hernia
A hernia is the protrusion of an organ through the wall of the cavity that normally contains it. The main risk is strangulation, which is a surgical emergency. Asymptomatic hernias can be safely observed, but severe pain is a symptom of strangulation. The most common hernias develop in the abdomen, when a weakness in the abdominal wall evolves into a localized hole, or "defect", through which adipose tissue, or abdominal organs covered with peritoneum, may protrude. Another common hernia involves the spinal discs and causes sciatica. A hiatus hernia occurs when the stomach protrudes into the mediastinum through the esophageal opening in the diaphragm.
A hernia is a protrusion of a tissue, structure, or part of an organ through the muscle tissue or the membrane by which it is normally contained. The hernia has three parts: the orifice through which it herniates, the hernial sac, and its contents.
A hernia is an opening or weakness in the muscular structure of the wall of the abdomen. This defect causes a bulging of the abdominal wall. This bulging is usually more noticeable when the abdominal muscles are tightened, thereby increasing the pressure in the abdomen.
By far the most hernias develop in the abdomen, when a weakness in the abdominal wall evolves into a localized hole, or "defect", through which adipose tissue, or abdominal organs covered with peritoneum, may protrude. Another common hernia involves the spinal discs and causes sciatica.
Hernias can be classified according to their anatomical location:
Hernia Examples include:
- abdominal hernias
- diaphragmatic hernias and hiatal hernias (for example, paraesophageal hernia of the stomach)
- pelvic hernias, for example, obturator hernia
- anal hernias
- hernias of the nucleus pulposus of the intervertebral discs
- intracranial hernias
A sportman's hernia is a syndrome characterized by chronic groin pain in athletes and a dilated superficial ring of the inguinal canal, although a true hernia is not present.
Since many organs or parts of organs can herniate through many orifices, it is very difficult to give an exhaustive list of hernias, with all synonyms and eponyms.
- Constipation - Because a hernia is often created by a portion of the small intestine pressing through the abdominal wall, it can negatively affect the digestive system. By constricting the small intestine, a hernia can cause constipation and other digestive problems.
- Lumps - While there is not always an external lump or bulge with a hernia, it is the most common indicator that a hernia is present. Often, hernia bulges in women are less visible than in men, especially when lying down, complicating a hernia diagnosis. Other times, a lump is only present in times of stress, like when coughing. If there is a bulge that feels rigid or will not go back into the body, this is referred to as a strangulated hernia, and it requires immediate medical attention.
- Pain - The earliest warning sign that a patient may be suffering from a hernia is if they feel persistent pain in their lower abdomen or groin. Hernia sufferers usually first experience pain after some sort of singular movement like lifting, coughing, or twisting that puts strain on the abdominal wall. Often this pain will slowly subside and then come back immediately the next time that motion or action is repeated. Persistent pain is the easiest determinant of a chronic problem like a hernia.
Each year, while an estimated 5 million Americans develop hernias, only 700,000 have them surgically repaired. Most physicians believe people avoid treating their hernias because they fear painful surgery. Today, there is little reason to fear. Hernia surgery is usually performed on an outpatient basis and patients are able to return to most normal activities in a matter of a few days.
It is generally advisable to repair hernias quickly in order to prevent complications such as organ dysfunction, gangrene, and multiple organ dysfunction syndrome. Most abdominal hernias can be surgically repaired, and recovery rarely requires long-term changes in lifestyle. Uncomplicated hernias are principally repaired by pushing back, or "reducing", the herniated tissue, and then mending the weakness in muscle tissue (an operation called herniorrhaphy).
Hernias usually need to be surgically repaired to prevent intestinal damage and further complications. The surgery takes about an hour and is usually performed on an outpatient basis (which means the patient can go home the same day of the procedure). This surgery may be performed by an open repair (small incision over the herniated area) or by laparoscopic surgery (minimally invasive). Your surgeon will determine the best method of repair for your individual situation.
Most patients will be able to go home a few hours after surgery. If needed, a 23-hour extended recovery area is available. Typically, most patients feel fine within a few days after the surgery and resume normal eating habits and activities. Strenuous activity and exercise are restricted for 4 to 6 weeks after surgery.
Congenital Diaphragmatic Hernia Awareness
The official congenital diaphragmatic hernia awareness ribbon, as voted on by CDH parents and survivors, is baby blue, pink and pale yellow with clouds. This awareness ribbon is recognized by members of the Alliance of Congenital Diaphragmatic Diaphragmatic Hernia Organizations. and by CHERUBS, the world's first and largest CDH organization with over 2800 members in 38 countries. April is Congenital Diaphragmatic Hernia Awareness Month as recognized by Capitol Hill and many governors and mayors. Each year, each U.S. state needs a request in order to issue a Proclamation or Resolution to have March 31st of that year Congenital Diaphragmatic Hernia Awareness Day.
Quick Facts: Hernia Causes &
Causes of hiatus hernia vary depending on each individual and include: improper heavy weight lifting, hard coughing bouts, sharp blows to the abdomen, and incorrect posture, obesity, straining during a bowel movement or urination (constipation, enlarged prostate), chronic lung disease, and also, fluid in the abdominal cavity (ascites). In addition, if muscles are weakened due to poor nutrition, smoking, and overexertion, hernias are more likely to occur.
- The lifetime risk of a groin hernia is 27% for men and 3% for women.
- Inguinal, femoral and abdominal hernias resulted in 32,000 deaths worldwide in 2013, or 0.5 per 100,000.
- The frequency of surgical correction ranges from 10 per 100,000 (U.K.) to 28 per 100,000 (U.S.).
Groin hernias occur in approximately 2% of the adult population and 4% of infants. Their relative frequencies are:
- Inguinal 80%
- Incisional 10%
- Femoral 5%
- Umbilical 4%
- Epigastric <1%
- Other: <1%