Inguinal hernia

Hernias are protrusions in the peritoneum caused by weaknesses in the abdominal wall. Visceral organs can be found in these protrusions, which are also known as hernia pouches. The weaknesses occur predominantly in places where large vessels push through the abdominal wall. This is most common in the inguinal canal (inguinal hernia) or in the femoral canal (femoral hernia).

What is an inguinal hernia?

An inguinal hernia, also called herniation, is the most common type of hernia. 

Hernias can principally occur all over the abdominal wall. Apart from the frequent localisation in the groin and in the femoral canal, a hernia can also sometimes occur in the area of the belly button (incisional hernia) 

Causes

General risk factors for hernias include:

  • A congenital weakness in the connective tissue.
  • Excessive weight as well as an increase in pressure in the abdomen, for example, when lifting heavy weights, chronic constipation with overstraining during bowel movements, or a chronic cough.
  • If the patient is pregnant, this also increases the risk of an inguinal hernia or a femoral hernia.

Hernias in other locations, such umbilical hernias after surgery, are mostly the result of an acquired abdominal wall weakness. 

What are the symptoms of an inguinal hernia?

Inguinal hernias or femoral hernias often cause few or no symptoms at all for the patient. The hernia pouch is not always visible or palpable from the outside of the body. If there is extensive fat tissue, it is particularly difficult to detect a hernia.

Sometimes stabbing pains occur in the groin. These can increase in strength when coughing or tensing the abdominal wall. If there are parts of the intestine in the hernia pouch, this can constrict the intestine. These are known as pinched (incarcerated) hernias. They are extremely painful and require surgery because they can damage the incarcerated area of the intestine.

Diagnosis

The patient’s medical history and a physical examination often already produce the diagnosis of an inguinal hernia. Coughing or straining usually causes the hernia to protrude and become palpable. An ultrasound is often also carried out in which the hernia is detectable.

Treatment of an inguinal hernia

The treatment depends on the symptoms and the size of the hernia. Incarcerated hernias and those which could potentially become incarcerated usually require surgery. A unilateral inguinal hernia is generally operated on an outpatient basis. Find out more about the surgical treatment options for hernias in the Herniotomy, hernia surgery section.

If the patient only has mild symptoms and there is a low risk of incarceration, the surgery can, depending on the situation, be put off. Patients should refrain from heavy lifting or overstraining during bowel movements so as not to worsen the hernia.

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