Hernia
Abnormal exit of tissue through the wall of its cavity.
A hernia is the abnormal exit of tissue or an organ, such as the bowel, through the wall of the cavity in which it normally resides. The term is also used for the normal development of the intestinal tract, referring to the retraction of the intestine from the extra-embryonal navel coelom into the abdomen in the healthy embryo at about 7½ weeks. Various types of hernias occur, most commonly involving the abdomen and specifically the groin, including inguinal, femoral, hiatus, incisional, and umbilical hernias.
- prevalence_2019
- 32.53 million prevalent cases of inguinal, femoral, and abdominal hernias globally
- incidence_2019
- 13.02 million incident cases globally
- lifetime_risk_males
- About 27% of males develop a groin hernia
- lifetime_risk_females
- About 3% of females develop a groin hernia
Lore & Background
Hernias occur when muscles and tendons in the belly weaken or become damaged, making it hard to keep internal organs in place. Pressure buildup inside the abdominal cavity can cause the wall to break, leading to a hernia that tends to enlarge over time. Risk factors include smoking, chronic obstructive pulmonary disease, obesity, pregnancy, peritoneal dialysis, collagen vascular disease, and previous open appendectomy. Predisposition is genetic, with dominant inheritance especially in men. It is unclear if groin hernias are associated with heavy lifting. Symptoms are present in about 66% of people with groin hernias, including pain or discomfort in the lower abdomen, especially with coughing, exercise, or urinating or defecating. A bulge may appear that becomes larger when bending down. Groin hernias occur more often on the right than left side. The main concern is bowel strangulation, where blood supply to part of the bowel is blocked, producing severe pain and tenderness. Hiatus hernias often result in heartburn but may also cause chest pain or pain while eating. Diagnosis is often based on signs and symptoms, with medical imaging used occasionally to confirm or rule out other causes. Hiatus hernias are often diagnosed by endoscopy. Groin hernias without symptoms in males do not need immediate surgical repair (watchful waiting), but most men eventually undergo surgery due to pain. For women, repair is generally recommended due to higher rates of femoral hernias. If strangulation occurs, immediate surgery is required. Repair may be done by open surgery, laparoscopic surgery, or robotic-assisted surgery.
Reader's Guide
Hernias represent a common medical condition with significant global burden. About 27% of males and 3% of females develop a groin hernia at some point. Healthcare costs associated with abdominal wall hernias account for an annual expenditure of approximately 2.5 to 3 billion dollars. Management varies by type and severity: asymptomatic groin hernias in males may be watched, while women typically undergo repair due to higher complication risks. Hiatus hernias are often treated with lifestyle changes and medications such as H2 blockers or proton pump inhibitors, with surgery (laparoscopic Nissen fundoplication) as an option if symptoms persist. The pathogenesis involves weakening of abdominal muscles and tendons, with pressure buildup causing a defect that enlarges over time. Complications include inflammation, obstruction, strangulation, hydrocele, hemorrhage, autoimmune problems, and irreducibility.
Did You Know?
- About 27% of males and 3% of females develop a groin hernia at some point in their lives.
- Groin hernias occur most often before the age of 1 and after the age of 50.
- It is unclear if groin hernias are associated with heavy lifting.
Frequently Asked Questions
What exactly is a hernia?
A hernia occurs when tissue or an organ, such as a loop of bowel, pushes through a weakened spot in the surrounding cavity wall. It can also refer to the normal embryonic process where the developing intestine retracts from the extra-embryonal navel coelom into the abdominal cavity around seven and a half weeks of gestation.
What are the main types of hernias fans should know about?
The most frequently encountered varieties are inguinal, femoral, hiatus, incisional, and umbilical hernias. All of them share the core mechanism of tissue escaping through a defect in the wall of the cavity that normally contains it.
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