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Ventral Hernia

(Abdominal Hernia; Incisional Hernia; Spigelian Hernia; Epigastric Hernia)

Definition

A ventral hernia is tissue that pushes through the front of the abdomen. Some types are:

  • Incisional hernia—develops along a previous surgical incision
  • Epigastric hernia—develops below the chest
  • Spigelian hernia—develops along the side of the abdomen (rare)

A hernia can trap part of the intestine. This is called strangulation. It needs care right away.

Ventral Hernia
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Causes

The problem is caused by a weakness in the muscles of the abdomen. It causes tissues inside to press through and form a hernia.

Risk Factors

Ventral hernias are more common in older adults. Other things that may raise the risk are:

  • Excess body weight
  • Heavy lifting
  • Coughing
  • Straining during bowel movements
  • Previous abdominal surgery
  • Problems after surgery, such as infection
  • Pregnancy

Symptoms

Some people do not have symptoms. Others may feel a bulge under the skin. Hernias can also cause pain. It may get worse during the day. Pain may occur with:

  • Heavy lifting
  • Coughing
  • Straining during bowel movements or urination
  • Sitting or standing for long periods of time

These serious symptoms may need care right away:

Diagnosis

The doctor will ask about your symptoms and health history. A physical exam may be done. This may be enough to make the diagnosis.

If the diagnosis is not clear, images of the belly may be taken. This can be done with:

Treatment

Ventral hernias are repaired with surgery. The tissue will be put back in place. The weakened area of the abdominal wall will be repaired.

People with a hernia that is cutting off blood flow may need this surgery right away.

Prevention

There are no known guidelines to prevent this health problem. Diet and exercise may help to:

  • Maintain a healthy weight
  • Keep abdominal muscles strong
RESOURCES:

American College of Gastroenterology
http://patients.gi.org

National Institute of Diabetes and Digestive and Kidney Diseases
https://www.niddk.nih.gov

CANADIAN RESOURCES:

Canadian Association of General Surgeons
https://cags-accg.ca

Health Canada
https://www.canada.ca

REFERENCES:

Hernias of the abdominal wall. Merck Manual Professional Version website. Available at: https://www.merckmanuals.com/professional/gastrointestinal-disorders/acute-abdomen-and-surgical-gastroenterology/hernias-of-the-abdominal-wall. Accessed January 8, 2021.

Incisional hernia. EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/incisional-hernia. Accessed January 8, 2021.

Laparoscopic ventral hernia repair from SAGES. Society of American Gastrointestinal Endoscopic Surgeons website. Available at: https://www.sages.org/publications/patient-information/patient-information-for-laparoscopic-ventral-hernia-repair-from-sages. Accessed January 8, 2021.

Trujillo C, Fowler A. Complex ventral hernias: a review of past to present. Perm J. 2018; 22: 17-015.

Ventral hernia. Dartmouth-Hitchcock website. Available at: http://www.dartmouth-hitchcock.org/hernia/ventral_hernia.html. Accessed January 8, 2021.

Last reviewed February 2020 by EBSCO Medical Review Board Marcin Chwistek, MD