Types of abdominal hernias

A hernia is a bulge of intestine, another organ, or fat through the muscles of the abdominal wall into the layer of the abdomen under the skin called the subcutaneous layer or into the groin (inguinal hernia). It may be caused by a birth defect, surgery, or the wear and tear of living. Several types other than inguinal hernias can develop in the abdominal wall. These are also called ventral hernias.

• A spigelian hernia occurs at the edge of the rectus muscles (the ones used in sit-ups) at the level of the navel. It is a relatively rare type of abdominal hernia that usually occurs in middle age. It can cause localized pain, as opposed to discomfort throughout the abdomen.
• An incisional hernia occurs after previous abdominal surgery, especially along a vertical (up and down) incision. This type of hernia may develop in people who are very overweight, are older, have used corticosteroids, or have had lung complications or a wound infection after surgery.¹ This type of hernia may be large and cause ongoing discomfort.
• An umbilical hernia develops in the navel; periumbilical hernias are around the navel. These often occur in infants, especially those of low birth weight, and many times heal on their own. They also may occur in adults who have conditions that cause increased abdominal pressure, such as obesity, pregnancy, or excess fluid in the abdomen (ascites) caused by cirrhosis.
• An epigastric hernia occurs in the middle of the abdomen between the breastbone and the navel. These hernias are usually small, and there may be several. They often have no symptoms but can cause upper abdominal pain. Fat usually protrudes through the weakness in the abdominal wall.

Imaging with ultrasound or computed tomography (CT) scan may be done to diagnose abdominal hernias. Surgery is needed to repair these hernias, usually using a piece of mesh to strengthen the repair and prevent the hernia from coming back.

Citations

1. Jeyarajah R, Harford WV (2006). Other ventral hernias section of Abdominal hernias and gastric volvulus. In M Feldman et al., eds., Sleisenger and Fordtran's Gastrointestinal and Liver Disease, 8th ed., vol. 1, pp. 487–489. Philadelphia: Saunders/Elsevier.