Hernias

A hernia is the protrusion of an organ or its fascia through the wall of the cavity that normally contains it.

• Inguinal hernia: Most common type, can be direct (medial to inferior epigastric vessels) or indirect (lateral to inferior epigastric vessels).
• Femoral hernia: Below the inguinal ligament, more common in females.
• Umbilical hernia: Protrusion at the umbilicus.
• Incisional hernia: Through a surgical scar.
• Hiatal hernia: Stomach protrudes into the thorax through the diaphragm.

• Lump: Often first noticed by the patient.
• Pain or discomfort, especially when lifting, coughing, or straining.
• Signs of bowel obstruction in strangulated hernias: Nausea, vomiting, abdominal pain.

• Lipoma.
• Lymphadenopathy.
• Abscess.
• Hydrocele.

• Clinical examination: Palpation and observation while patient coughs or strains.
• Ultrasound: To confirm diagnosis and differentiate from other lumps.
• CT/MRI: Useful in complex or recurrent cases.

• Elective surgical repair for symptomatic hernias or those at risk of complications.
• Watchful waiting for asymptomatic inguinal hernias in older patients.
• Laparoscopic or open hernia repair.
• Emergency surgery for strangulated hernias.

• Strangulation: Compromised blood supply leading to tissue necrosis.
• Obstruction: Bowel gets trapped in the hernial sac.
• Incisional hernias can result in wound dehiscence (wound splitting open).

• A hernia is the protrusion of an organ or its fascia through the wall of its cavity, with the most common type being an inguinal hernia.
• Early diagnosis and management is required to reduce complications, such as bowel strangulation.
• Patient often presents with a lump, which can cause discomfort when straining or coughing.
• Diagnosis is primarily through clinical examination, with ultrasound to confirm diagnosis.
• Management is dependent on type of hernia and presentation, including watchful waiting, elective surgical repair or emergency surgery (strangulated hernias).