Groin & Abdominal Wall Hernias

A hernia occurs when part of your body protrudes through an abnormal opening in the groin or abdominal wall. A hernia can be present at birth, develop over years, or come on suddenly.

The underlying causes of hernias are increased pressure within the abdomen and generalized weakness of connective tissues. Since these conditions affect both sides of the groin or abdomen equally, people who have one hernia often have more, even if they are only experiencing pain on one side. Consequently, both sides will be carefully examined for hernias. This is important since an additional asymptomatic hernia may affect the type of repair your surgeon elects to perform.

Although hernias aren’t dangerous themselves, they can have life-threatening complications, and hernias certainly can cause pain, even when not dangerous.

This page contains the following information about groin and abdominal wall hernias:

Facts About Groin & Abdominal Wall Hernias

Groin and abdominal wall hernias are a common problem. The National Center for Health Statistics estimates that about 5 million people in the United States have such a hernia.

The signs of a hernia include an abnormal bulge in the groin or abdominal wall, pain, and tenderness directly over the hernia. Most hernias contain only fat and membranes. A small percentage contains bowel and/or peritoneal fluid (fluid that surrounds the gastrointestinal organs).

Types of Groin & Abdominal Wall Hernias

There are several types of groin and abdominal wall hernias, as the following chart shows:

Type Description Additional Information
Inguinal Develops in the groin area. Accounts for 75% of abdominal wall hernias and most often occurs in men.
Femoral Appears in the upper thigh, just below the groin crease. Less common hernia that usually occurs in women, probably because of increased intra-pelvic pressure during pregnancy.
Spigelian Occurs at the edge of the rectus muscles (the ones used to sit up), near the level of the navel. This rare type of hernia usually occurs in middle-age.
Incisional Occurs through a surgical scar in the abdomen. Most often occurs in obese patients or when the surgical site was infected. May occur months or years after surgery.
Midline Includes umbilical (around the navel), epigastic (above the navel), and hyogastric (below the navel) abdominal hernias. Umbilical hernias often occur in infants and usually heal on their own. All midline hernias can be acquired or congenital. The majority are prone to being nonreducible.

Reducibility

A hernia can be completely reducible, incompletely reducible, or non-reducible. When the tissue creating the bulge can be pushed back into the abdomen, or completely flattened, it is reducible. If the tissue cannot be pushed back into the abdomen, the hernia is non-reducible.

Strangulation

Non-reducible hernias are more likely to cause pain and are more likely to become strangulated. Strangulation results when the blood and lymphatic vessels that supply the contents of the hernia become “pinched” as they pass through the neck of the hernia, interfering with the blood supply to hernia contents, and potentially leading to death of those tissues. Strangulated hernias that contain only fat can cause severe pain, but are not life-threatening. However, when a hernia that contains bowel becomes strangulated, life threatening complications such as bowel obstruction and bowel death (infarction) can occur.

By diagnosing hernias early, they can be surgically repaired before strangulation can occur.

Risk Factors for Groin & Abdominal Wall Hernias

Anyone of any age can develop a hernia. Some hernias have no apparent cause, but many occur because of a pre-existing weak spot in the abdominal wall and/or excess pressure on the abdomen.

The following factors can increase your risk for developing a hernia:

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Reducing the Risk of Groin & Abdominal Wall Hernias

Many hernias are not preventable. However, adults may be able to prevent some hernias, or prevent the recurrence of a hernia by following these guidelines:

Symptoms of Groin & Abdominal Wall Hernias

A hernia usually becomes noticeable as a bulge in the abdomen, groin, scrotum or upper thigh (depending on the type of hernia). If the hernia is reducible, it may change size based on your position. Sometimes hernias do not cause a bulge and may not be noticed unless other symptoms occur.

Following are additional symptoms of hernias:

Imaging Exams for Detecting Groin & Abdominal Wall Hernias

Your physician may order an ultrasound to diagnose a hernia or to characterize the contents of a hernia and determine its reducibility. Ultrasound is the ideal exam for evaluating hernias because it is performed in real time, showing live motion. It can be performed while the patient is lying on his or her back or standing upright; while breathing quietly or straining vigorously. Additionally, the hernia can be compressed during the exam. All these factors enable ultrasound to more accurately identify the type, number, and character of hernias. Ultrasound can also identify small hernias, allowing them to be repaired before strangulation occurs.

Learn more about the preferability of ultrasound over CT and MRI scans for diagnosing hernias.

Radiology Procedures for Treating Groin & Abdominal Wall Hernias

There are no radiology procedures for treating hernias.

Strangulated hernias require immediate surgical repair. Non-strangulated hernias generally can undergo elective surgical repair. Small “incidental” hernias that contain only fat may not require surgery. The decision to undergo surgical repair of a hernia (herniorrhaphy), and the type of repair, must be decided by the patient in conjunction with advice from his or her primary care physician, and/or a surgeon.

Additional Information on Groin & Abdominal Wall Hernias

The information on this page was taken in part from the following sources. Visit the listed web sites for additional information on groin and abdominal wall hernias.

Sources

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