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Hernia


Alternative Names:

Hernia - inguinal; Inguinal hernia; Direct and indirect hernia; Rupture; Strangulation; Incarceration

Causes, incidence, and risk factors:

Usually, there is no obvious cause of a hernia. Sometimes hernias occur with heavy lifting, straining while using the toilet, or any activity that raises the pressure inside the belly area. Hernias may be present at birth, but the bulge may not be noticeable until later in life. Some patients may have a family history of hernias.

Babies and children can get hernias. It happens when there is weakness in the belly wall. About 5 out of 100 children have inguinal hernias. They are more common in boys. Some children may not have symptoms until they are adults.

Any activity or medical problem that increases pressure on the tissue in the belly wall and muscles may lead to a hernia, including:

Symptoms:

There are usually no symptoms. Some people have discomfort or pain. The discomfort may be worse when you stand, strain, or lift heavy objects. In time, most people will complain about a bump that is sore and growing. 

If a hernia gets bigger, it may get stuck inside the hole and lose its blood supply. This is called "strangulation."  If this occurs, you will need urgent surgery.

Signs and tests:

Your doctor or nurse can usually see or feel a hernia when they examine you. You may be asked to cough, bend, push, or lift. The hernia may get bigger when you do this.

The hernia (bulge) may not be easily seen in infants and children, except when the child is crying or coughing. 

 Ultrasound or CT scans may be done to look for a hernia.

If you may have a blockage in your bowel, you will need an x-ray of the abdomen.

Expectations (prognosis):

The outcome for most hernias is usually good with treatment. It is rare for a hernia to come back. Incisional hernias are more likely to return.

Complications:

In rare cases, inguinal hernia repair can damage structures involved in the function of a man's testicles.

Another risk of hernia surgery is nerve damage, which can lead to numbness in the groin area.

If a part of your bowel was trapped or strangulated before surgery, it may lead to a bowel perforation or dead bowel.

Calling your health care provider:

Call your doctor right away if:

  • You have a painful hernia and the contents cannot be pushed back into the abdomen using gentle pressure
  • You develop nausea, vomiting, or a fever along with a painful hernia
  • You have a hernia that becomes red, purple, dark, or discolored

Call your doctor if:

  • You have groin pain, swelling, or a bulge
  • You have a bulge or swelling in the groin or belly button, or that is associated with a previous surgical cut.
Prevention:
  • Use proper lifting techniques.
  • Lose weight if you are overweight.
  • Relieve or avoid constipation by eating plenty of fiber, drinking lots of fluid, going to the bathroom as soon as you have the urge, and exercising regularly.
  • Men should see their health care provider if they strain with urination. This may be a symptom of an enlarged prostate.
References:

Turnage RH, Badgwell B. Abdominal wall, umbilicus, peritoneum, mesenteries, omentum, and retroperitoneum. In: Townsend CM, ed. Sabiston Textbook of Surgery. 19th ed. Philadelphia, Pa: Saunders Elsevier;2012:chap 45.


Review Date: 12/10/2012
Reviewed By: Robert A. Cowles, MD, Associate Professor of Surgery, Yale University School of Medicine, New Haven, CT. Review provided by VeriMed Healthcare Network. Also reviewed by A.D.A.M. Health Solutions, Ebix, Inc., Editorial Team: David Zieve, MD, MHA, David R. Eltz, and Stephanie Slon.

The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed physician should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. Copyright 2002 A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.

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