An abdominal hernia occurs when an organ, like part of the intestine, pushes through a weak spot in the abdominal wall muscles. This common condition often requires surgery. While generally safe, abdominal hernia surgery carries potential complications. Understanding these can help patients prepare for recovery.
Complications Occurring Soon After Surgery
Infections can develop soon after surgery. A common type is superficial wound infection, manifesting as redness, warmth, swelling, and pus at the incision site within days to weeks. Less commonly, a deeper infection involving surgical mesh, if used, can occur, leading to more severe symptoms and requiring further treatment.
Bleeding beneath the skin or within the surgical site can lead to a hematoma, a collection of blood appearing as a bruise or painful lump. Another common fluid collection is a seroma, a clear or yellowish fluid buildup under the skin. Both hematomas and seromas usually resolve on their own, but larger ones might require drainage.
Patients will experience some discomfort, but acute pain severe, worsening, or unresponsive to pain medication can signal a complication. This pain might indicate an infection, hematoma, or other issues. Difficulty urinating, known as urinary retention, can also occur, particularly after general anesthesia or due to pain medication. This typically resolves once anesthesia wears off, or require temporary catheterization.
Early bowel obstruction can sometimes develop due to swelling or kinking of bowel loops around the surgical site. Symptoms include severe abdominal pain, nausea, vomiting, and an inability to pass gas or stool. Nerve injury, while less frequent, can manifest as numbness, tingling, or altered sensation around the incision or in the groin. This results from nerve irritation or stretching during the procedure and often improves over weeks or months.
Long-Term Complications
Chronic pain is a common long-term concern following abdominal hernia repair, persisting for months or years. This pain can range from a dull ache to sharp sensations, sometimes impacting daily activities. It may stem from nerve entrapment, scar tissue formation, or chronic inflammation around the surgical site or mesh.
Hernia recurrence, where the hernia reappears, is another long-term complication. This can happen months or years after repair, with rates varying by hernia type, surgical technique, and patient factors. Factors contributing to recurrence include excessive strain on the repair, poor tissue healing, or previous failed repairs.
When surgical mesh is used, it can lead to specific late-onset complications. Although rare, a mesh infection can develop months or even years post-surgery, requiring prolonged antibiotic treatment or removal. Mesh migration, where the mesh moves, or erosion into adjacent organs like the bowel or bladder, are serious but infrequent complications that may necessitate further surgery. Chronic inflammation or a foreign body reaction to the mesh can also occur, potentially contributing to persistent discomfort or pain.
Adhesions, bands of scar tissue, can form inside the abdomen after any surgery. While many adhesions cause no problems, they can sometimes lead to issues like chronic abdominal pain or, more seriously, late bowel obstruction. Adhesions can restrict the movement of the intestines, potentially causing blockages that require medical attention or additional surgery.
Recognizing and Responding to Complications
Recognizing the warning signs of complications after hernia surgery is important for timely intervention. A fever above 100.4°F (38°C) can indicate an infection. Increasing redness, swelling, warmth, or discharge from the incision site, especially if thick or foul-smelling, are also signs of a possible wound infection.
Persistent or worsening pain unresponsive to prescribed medication, or new severe pain, should prompt medical evaluation. Nausea and vomiting that continue or worsen, especially with inability to pass gas or stool, could signal a bowel obstruction. A new bulge at or near the surgical site, or a return of the original hernia bulge, indicates potential recurrence.
Patients should contact their surgeon promptly if they notice any of these symptoms. For more severe or rapidly worsening symptoms, such as sudden, severe abdominal pain, persistent vomiting, high fever with chills, or signs of shock (dizziness, rapid heart rate), seeking emergency medical care is advisable. Early recognition and communication with healthcare providers can lead to more effective management and better outcomes.
Factors That Increase Risk
Several factors can increase the risk of complications after abdominal hernia surgery. Patient-related factors include obesity, which places tension on the repair and impairs wound healing. Smoking negatively affects tissue healing, increasing the risk of wound complications and recurrence. Diabetes can also compromise wound healing and increase susceptibility to infection.
Advanced age and poor nutritional status can hinder healing after surgery. Chronic conditions that increase abdominal pressure, such as a persistent cough or constipation, can also strain the repair, elevating the risk of recurrence. Certain medications, like steroids, can suppress the immune system and impair wound healing, potentially increasing complications.
Hernia characteristics also play a role in complication risk. Larger hernias often involve more extensive repairs, leading to more complications. Recurrent hernias, those that have returned, are generally more complex to fix and carry a greater risk of recurrence and other complications. Emergency surgery for an incarcerated (trapped) or strangulated (blood supply cut off) hernia also carries a higher risk of complications due to urgency and potential tissue damage and infection. Surgical procedure complexity and technique, including mesh type, can also influence complication likelihood.