Definition A hernia is the protrusion of an organ or its fascia through the wall of the cavity that normally contains it. Types of Hernias 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. Clinical Presentation 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. Complications 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). Investigations 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. Management 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. Differential Diagnoses Lipoma, lymphadenopathy, abscess, hydrocele, and more.
