Different types of abdominal hernias are as follows:
- Inguinal (groin) hernia: Making up 75% of all abdominal wall hernias and
occurring up to 25 times more often in men than women, these hernias are
divided into two different types, direct and indirect. Both occur in the groin
area where the skin of the thigh joins the torso (the inguinal crease), but they
have slightly different origins. Both of these types of hernias can similarly
appear as a bulge in the inguinal area. Distinguishing between the direct and
indirect hernia, however, is important as a clinical diagnosis.
- Indirect inguinal hernia: An indirect hernia follows the pathway that
the testicles made during fetal development, descending from the
abdomen into the scrotum. This pathway normally closes before birth
but may remain a possible site for a hernia in later life. Sometimes the
hernia sac may protrude into the scrotum. An indirect inguinal hernia
may occur at any age.
- Direct inguinal hernia: The direct inguinal hernia occurs slightly to the
inside of the site of the indirect hernia, in an area where the abdominal
wall is naturally slightly thinner. It rarely will protrude into the scrotum
and can cause pain that is difficult to distinguish from testicle pain.
Unlike the indirect hernia, which can occur at any age, the direct hernia
tends to occur in the middle-aged and elderly because their abdominal
walls weaken as they age.
- Femoral hernia: The femoral canal is the path through which the femoral
artery, vein, and nerve leave the abdominal cavity to enter the thigh. Although
normally a tight space, sometimes it becomes large enough to allow
abdominal contents (usually intestine) to protrude into the canal. A femoral
hernia causes a bulge just below the inguinal crease, in roughly the mid-thigh
area. Usually occurring in women, femoral hernias are particularly at risk of
becoming irreducible (not able to be pushed back into place) and
strangulated. Not all hernias that are irreducible are strangulated (have their
blood supply cut off), but all hernias that are irreducible need to be evaluated
by a hernia doctor in Kolkata.
- Umbilical hernia: These common hernias (10%-30%) are often noted at birth
as a protrusion at the belly button (the umbilicus). This is caused when an
opening in the abdominal wall, which normally closes before birth, doesn't
close completely. If small (less than half an inch), this type of hernia usually
closes gradually by age 2. Larger hernias and those that do not close by
themselves usually require surgery between 2 to 4 years of age. Even if the
area is closed at birth, umbilical hernias can appear later in life because this
spot may remain a weaker place in the abdominal wall. Umbilical hernias can
appear later in life or in women who are pregnant or who have given birth
(due to the added stress on the area). They usually do not cause abdominal
- Incisional hernia: Abdominal surgery causes a flaw in the abdominal wall.
This flaw can create an area of weakness through which a hernia may
develop. This occurs after 2%-10% of all abdominal surgeries, although some
people are more at risk. Even after surgical repair, incisional hernias may
- Spigelian hernia: This rare hernia occurs along the edge of the rectus
abdominis muscle through the Spigelian fascia, which is several inches lateral
to the middle of the abdomen.
- Obturator hernia: This extremely rare abdominal hernia develops mostly in
women. This hernia protrudes from the pelvic cavity through an opening in the
pelvic bone (obturator foramen). This will not show any bulge but can act like
a bowel obstruction and cause nausea and vomiting. Because of the lack of
visible bulging, this hernia is very difficult to diagnose.
- Epigastric hernia: Occurring between the navel and the lower part of the rib
cage in the midline of the abdomen, epigastric hernias are composed usually
of fatty tissue and rarely contain intestine. Formed in an area of relative
weakness of the abdominal wall, these hernias are often painless and unable
to be pushed back into the abdomen when first discovered.
- Hiatal hernia: This type of hernia occurs when part of the stomach pushes
through the diaphragm. The diaphragm normally has a small opening for the
esophagus. This opening can become the place where part of the stomach
pushes through. Small Hiatal hernias can be asymptomatic (cause no
symptoms), while larger ones can cause pain and heartburn.
All newly discovered hernias or symptoms that suggest you might have a hernia
should prompt a visit to the doctor. Hernias, even those that ache, if not tender and
easy to reduce (pushed back into the abdomen), are not necessarily surgical
emergencies, but all have the potential to become serious. Referral to a hernia
surgeon in Kolkata should generally be made so that the need for surgery can be
established and the procedure can be performed as elective surgery. This helps to
avoid the risk of emergency surgery if your hernia becomes irreducible or
If you find a new, painful, tender, and irreducible lump, it means that you may have
an irreducible hernia, and you should have it checked in an emergency setting. If you
already have a hernia and it suddenly becomes painful, tender, and irreducible, you
should also go to the emergency department. Strangulation of intestine within the
hernia sac can lead to gangrenous (dead) bowel in as little as six hours. Not all
irreducible hernias are strangulated, but they need to be evaluated.
Hernia treatment consists of surgery unless you have medical conditions that
preclude surgery. In some cases, belts or trusses can be used to temporarily hold
the hernia in place.
In general, all hernias should be repaired unless severe pre-existing medical
conditions make surgery unsafe. The possible exception to this is a hernia with a
large opening. Trusses and surgical belts or bindings may help hold back the
protrusion of selected hernias when hernia surgery in Kolkata is not possible or must
be delayed. However, they should never be used in the case of femoral hernias.
Avoid activities that increase intra-abdominal pressure (lifting, coughing, or
straining), which may cause the hernia to increase in size.
ALL HERNIA PATIENTS SHOULD UNDERGO SURGERY UNLESS THE RISK IS