A ventral hernia can occur when abdominal tissue or an organ part bulges through an aperture or weakened portion of the abdominal wall. An incisional hernia is a common type of ventral hernia. When classified as reducible, a hernia can be pushed back into the abdominal cavity. In most cases, a reducible ventral hernia may not present immediate problems; however, over time it may grow in size, cause pain and eventually require surgery.
The Facts
Ventral hernias usually occur when contents contained in the abdominal cavity protrude through a weak region of the abdominal wall resulting in a sac or bulge. The contents of this sac can be abdominal tissue or parts of the intestines. Hernias can be classified as either reducible or irreducible/incarcerated depending on whether they can be placed back into the abdomen. Irreducible or incarcerated hernias cannot be placed back into the abdominal cavity and can become strangulated (the blood supply to the area is cutoff). A strangulated hernia can require immediate surgery.
Ventral hernias are just one type of the many abdominal hernias that can affect people. Likewise, there are also different types of ventral hernias.
Types
Incisional hernias are the most common types usually associated with this medical condition. An incisional hernia occurs at the location of a surgical incision. According to Dartmouth-Hitchcock Medical Center, approximately one-third of patients who have open abdominal surgery may develop a ventral hernia at these sites.
Some other types of ventral hernias include umbilical, epigastric and spigelian hernia.
Causes
Because hernias may develop in weakened regions of the abdomen, any major increase in pressure experienced in these areas may be contributing factors in the development of a ventral hernia. Some common factors are strenuous physical activity, lifting heavy objects, chronic coughs and straining. Other causes that may increase a person's chance of developing this condition are obesity, old surgical scar, aging, infection at an incision site or an injury.
Symptoms
In most cases, the only sign of a reducible ventral hernia may be the noticeable bulge without any discomfort or pain. This bulge may be large or small. However, some people may experience pain or discomfort while lifting heavy objects, coughing or standing for long periods. When a person experiences symptoms such as vomiting, nausea or redness in the affected area, these can be signs of a strangulated hernia. Strangulated hernias are irreducible hernias and require immediate medical attention.
Consideration
Because most hernias tend to increase in size with the progression of time and may cause complications, surgery is often advisable. However, doctors must evaluate each patient to determine the best option. In some cases, patients who have certain medical conditions or have a ventral hernia in a difficult position may not be candidates for surgery.
According to the Society of American Gastrointestinal and Endoscopic Surgeons, there are about 90,000 ventral hernia repair surgeries performed annually in the United States.
Treatment
Reducible ventral hernias that are small may be pushed back into the proper place in the abdominal cavity and require no additional treatments. Doctors may advise a patient with a reducible ventral hernia to wear a truss or supportive belt. However, this may not be an effective treatment, as hernias tend to increase in size with time. Doctors also can choose to monitor patients who cannot have surgery because of serious medical problems.
After a thorough examination of a patient, doctors may recommend surgery when it is the best option to correct this medical condition. There are two types of surgical repairs possible: traditional open hernia repair and laparoscopic repair. In an open hernia repair for a ventral hernia, doctors make an incision and push the content back into place. Laparoscopic repair involves using a telescope and camera. Not all people are good candidates for this procedure.
