A hernia is a medical condition in which an internal organ bulges or protrudes through the tissue that normally surrounds it. The type of hernia we hear about most often is the abdominal hernia, when a weakness in the abdominal muscle results in a separation allowing the intestines to push through the opening and cause a visible lump.
Hernia Types by Severity
As the opening in the abdominal muscles widens, more and more of the intestines are able to protrude through. If the intestines can be manipulated back where they belong, the condition is called a reducible hernia. But even though the intestines can be temporarily pushed back in place, they will soon protrude again through the weakened area. Treatment for a reducible hernia is optional, but often undertaken to prevent the condition from becoming worse.
When the part of the intestines bulging through the hernia becomes trapped and cannot be manipulated back into the abdominal cavity, the condition is called an incarcerated hernia. This can potentially result in an intestinal blockage in which case immediate surgery is required to repair the condition.
When the protruding intestines are pinched by the opening they’ve pushed through, the blood supply to that segment of the intestines can be cut off. This condition, called strangulation, can cause gangrene to set in and is considered a medical emergency.
Hernia Types by Location
Also called a groin hernia, the inguinal hernia is the most common type. Occurring far more often in men than women, inguinal hernias represent about 75% of all hernias. They are located just above the crease where the leg meets the torso on either the left or right side.
Indirect Inguinal Hernia
An indirect inguinal hernia is located along one of two paths through the abdominal wall where the testes descend into the scrotum during embryological development. These openings close up before birth but represent a potential weak spot where a hernia can sometimes occur. The hernia may even protrude into the scrotum. The indirect inguinal hernia can occur at any age, and can even appear in newborns. Though it can occur in both sexes, boys are far more likely to experience an indirect inguinal hernia than girls.
Direct Inguinal Hernia
The direct inguinal hernia becomes increasingly common among men as they grow older. It often occurs when strain is put on abdominal muscles that have weakened with age. That is why you may often hear the precaution against an older man lifting a heavy object so he doesn’t “give himself a hernia.”
The femoral hernia occurs in nearly the same groin area as an inguinal hernia, but descends near the femoral canal where nerves and blood vessels travel through the abdomen to the legs. Femoral hernias are far more common in women than men, and are also very likely to result in incarceration or strangulation if not treated promptly.
An umbilical hernia appears as a lump near the belly button, and is somewhat common in infants, occurring in one out of five births. This abdominal defect typically closes on its own within one to four years.
In adults, an umbilical hernia is near the navel but not actually through it, as in infants. This type of hernia is more common among pregnant women and the obese. Corrective surgery is usually required to prevent occurrence of an incarcerated or strangulated hernia.
This type of hernia occurs at the site of abdominal surgery where the scar tissue is stretched or becomes weak. Pregnancy, weight gain, and physical activity that strains the site of a previous surgery can contribute to an incisional hernia. These have a tendency to be larger openings leading to a more unsightly protrusion of organs.
Some publications use the term ventral hernia as a synonym for an incisional hernia. Others use ventral hernia to describe abdominal hernias in general.
A diaphragmatic hernia is a birth defect in which an opening occurs in the muscle (diaphragm) separating the abdominal space from the chest cavity. The opening allows some of the abdominal organs to pass through into the chest area before birth. This interferes with normal development of the lungs and other organs and results in a medical emergency at birth. Surgery to put the infant’s organs in their proper place and repair the defect is often followed by an extended recovery period on a ventilator or heart-lung machine to allow the organs to finish developing.
The esophagus passes through the diaphragm through an opening called the esophageal hiatus, and then promptly joins the stomach. When the esophageal hiatus becomes enlarged, a portion of the stomach can push upward through the opening resulting in a hiatal hernia. Most people with a small hiatal hernia will never know it. A larger hernia can cause chronic heartburn, and may require surgical correction.