An incisional hernia is a common post-operative issue that can develop after abdominal surgery. Recognizing the various ways this condition presents is an important first step in seeking appropriate medical guidance and preventing potential complications. This information helps identify potential issues related to a previous surgical scar so you can consult a healthcare provider.
Understanding the Incisional Hernia
An incisional hernia is a type of ventral hernia where internal tissue, such as a part of the intestine or abdominal fat, pushes through a weakness in the abdominal wall. This weakness occurs at or near the site of a previous surgical incision that failed to heal adequately. The surgical cut disrupts the abdominal muscles and fascia, the strong connective tissue that normally contains the internal organs.
The failure of this repaired tissue creates a defect through which abdominal contents can protrude. While this issue most often surfaces within three to six months following the initial procedure, it can appear months or even years later. Increased pressure on the abdomen, such as from weight gain, pregnancy, or strenuous activity before full healing, often contributes to the hernia’s formation.
The Most Common Localized Symptoms
The most defining symptom of an incisional hernia is a noticeable lump or bulge appearing near the surgical scar. This protrusion represents abdominal contents pushing through the muscle defect and is often soft to the touch. The bulge’s visibility typically increases with a rise in intra-abdominal pressure, such as when standing, coughing, straining, or lifting heavy objects.
A key characteristic of an uncomplicated incisional hernia is that the bulge may lessen or disappear entirely when the person lies down. This is known as a reducible hernia, where the contents slide back into the abdominal cavity as internal pressure is reduced. The bulge’s texture can range from small and firm to larger and soft, but it is always localized to the area of the previous operation.
Discomfort or pain at the incision site is also a frequent localized complaint. This sensation can vary widely, presenting as a dull, constant ache, a feeling of heaviness, or a sharp, burning pain. The pain is usually exacerbated by physical activities that engage the abdominal muscles, such as bending or prolonged standing. Some individuals also describe a distinct pulling or tugging sensation in the affected area.
Related Digestive System Indicators
When the protruding tissue involves a section of the bowel, symptoms extend beyond localized discomfort to affect digestive function. This occurs because the loop of intestine trapped within the hernia sac can become compressed or partially obstructed.
A common digestive indicator is a change in bowel habits, particularly the onset of constipation or difficulty passing gas. The partial blockage prevents the normal flow of waste through the digestive tract. People may also experience a feeling of persistent fullness or bloating in the abdomen, even when they have not eaten a large meal.
Nausea, and in some cases vomiting, can accompany the localized discomfort, signaling that the intestinal tract is under strain.
Recognizing Emergency Signs of Complication
Certain symptoms signal that an incisional hernia has progressed to a complicated state requiring immediate medical attention. A serious complication is incarceration, where the protruding tissue becomes firmly trapped and cannot be pushed back into the abdomen. This is often accompanied by a sudden, significant increase in pain that is severe and constant.
The most dangerous progression is strangulation, where the blood supply to the trapped tissue is cut off, leading to tissue death, or necrosis. Signs of strangulation include the hernia bulge becoming tender, hard, and possibly turning a dark red, purple, or bluish color. Systemic symptoms indicating this emergency include the onset of fever, a rapidly beating heart, and persistent vomiting. If these signs appear, it is imperative to seek emergency medical care immediately.