A hernia occurs when an organ or fatty tissue protrudes through a weak spot in surrounding muscle or connective tissue. This weakness allows internal contents to bulge outwards, forming a noticeable lump. While often found in the abdomen, hernias can develop in various body areas. Understanding their different types is important for recognizing potential health concerns.
Common Abdominal Wall Hernias
The abdominal wall is a common site for hernias. Inguinal hernias are the most common type, particularly in men, occurring in the groin. They involve abdominal tissue, like fat or intestine, pushing through an opening in the lower abdominal wall’s inguinal canal. This can appear as a bulge near the pubic bone, sometimes extending into the scrotum in males. Inguinal hernias are direct, pushing through a weakened area, or indirect, often due to a congenital defect where the canal opening doesn’t fully close after birth.
Umbilical hernias develop around the navel. They occur when fatty tissue or bowel protrudes through a weakness in the abdominal wall near the umbilicus. Common in infants due to incomplete umbilical opening closure, they can also affect adults, often from increased abdominal pressure. The bulge may become more noticeable during activities like crying or coughing in infants.
Incisional hernias form at the site of a previous surgical incision where the abdominal wall was compromised. Weakened scar tissue allows internal fat or intestines to protrude, creating a bulge often more apparent with coughing, straining, or heavy lifting. These hernias can appear months or years after surgery, developing anywhere an abdominal incision was made.
Femoral hernias are less common than inguinal hernias, appearing in the upper thigh below the groin crease. They occur when abdominal contents push through the femoral canal, a narrow passageway containing the femoral artery, veins, and nerves. More frequent in women, partly due to a wider bony pelvis, femoral hernias have a higher risk of complications if trapped due to the canal’s narrowness.
Diaphragmatic and Other Less Common Hernias
Hernias can also occur in less common locations, such as the diaphragm, the muscle separating the chest and abdomen. A hiatal hernia is a diaphragmatic hernia where part of the stomach pushes through an opening in the diaphragm, called the hiatus, into the chest cavity.
There are two types of hiatal hernias. A sliding hiatal hernia, the most common, occurs when the junction between the esophagus and stomach, along with part of the stomach, slides into the chest through the hiatus. A paraesophageal hiatal hernia involves a portion of the stomach bulging alongside the esophagus, while the esophageal-stomach junction remains normal. Hiatal hernias may not cause symptoms, but they can sometimes lead to issues like acid reflux or heartburn.
Other less common hernias exist. An epigastric hernia develops in the upper middle abdomen, between the breastbone and navel, when fatty tissue pushes through a weak spot in the linea alba, the central abdominal connective tissue. Spigelian hernias are rare, forming along the semilunar line, which is the lateral edge of the rectus abdominis muscle, often making them less visible externally. An obturator hernia is another rare type, occurring when abdominal contents protrude through the obturator foramen in the pelvic floor, often undetected due to its internal location.
Recognizing Hernia Symptoms and When to Seek Help
Many hernias present with a visible bulge or lump in the affected area, though some may not cause symptoms. This bulge often becomes more prominent during activities that increase abdominal pressure, like coughing or straining, and may disappear when lying down. Symptoms can include pressure, a dull ache, sharp pain, burning, or a feeling of heaviness in the groin or abdomen, intensifying with physical exertion or lifting. If a hernia causes frequent discomfort or pain, or if new symptoms arise, consult a healthcare professional for diagnosis. Early evaluation helps prevent potential complications like incarceration (trapped hernia) or strangulation (blood supply cut off), which require immediate medical attention.