A hernia generally occurs when an internal part of the body pushes through a weakness in the muscle or surrounding tissue wall. This can result in a noticeable bulge, often in the abdomen or groin. A ventral hernia is a specific kind that forms in the front abdominal wall. Understanding this condition involves recognizing its characteristics, symptoms, and how it develops.
What is a Ventral Hernia?
A ventral hernia involves the protrusion of tissue or an organ, such as the intestine, through a weakened area or gap in the abdominal wall. The term “ventral” refers to the front or belly area, indicating these hernias appear on the anterior abdominal wall. This wall is composed of layers of muscle, fascia, fat, and skin that enclose the abdominal organs.
When these layers are compromised, contents from inside the abdomen can push outward, creating a visible bulge. Common types of ventral hernias include umbilical hernias, which develop around the navel, and epigastric hernias, found between the navel and the breastbone. Incisional hernias are another frequent type, occurring at the site of a previous surgical incision in the abdomen.
Common Symptoms to Look For
A common symptom of a ventral hernia is a noticeable bulge in the abdominal area. This bulge may become more apparent during activities that increase abdominal pressure, such as standing, coughing, or lifting. Sometimes, the bulge may recede or disappear when lying down.
Individuals with a ventral hernia may also experience pain, pressure, aching, or a burning sensation at the hernia site. This discomfort can vary in intensity and may worsen with physical activity or prolonged standing. While some people may have a painless lump, others might experience associated symptoms like nausea or vomiting, especially if the hernia involves the intestine.
Why Ventral Hernias Develop
Ventral hernias arise from a weakening or opening in the abdominal wall muscles. This weakness can be present from birth or develop over time. Prior abdominal surgery is a common cause, as incisional hernias form where the surgical incision weakens the abdominal wall.
Increased pressure within the abdomen contributes to hernia formation. Factors like obesity, chronic coughing, frequent heavy lifting, and straining during bowel movements create this pressure. Pregnancy also places considerable strain on abdominal muscles, potentially leading to hernia development. Certain medical conditions, such as chronic obstructive pulmonary disease (COPD) or diabetes, and the natural aging process, can weaken connective tissues and muscle strength, increasing susceptibility to hernias.
How Ventral Hernias Are Diagnosed and Treated
Diagnosing a ventral hernia begins with a physical examination by a healthcare provider. During this exam, the provider will look for and feel any lumps or protrusions in the abdomen, often asking the patient to stand or cough to make the hernia more evident. This allows assessment of the hernia’s size and whether it can be gently pushed back into the abdomen.
If the physical exam is inconclusive or to better understand the hernia’s contents, imaging tests may be used. These include ultrasound, CT, or MRI scans, which provide detailed views of abdominal structures. These tests help confirm the diagnosis and rule out other conditions.
Surgery is the primary treatment for ventral hernias, as they do not heal on their own and can worsen. The surgical procedure, known as herniorrhaphy, involves pushing the protruding tissue back into the abdomen and repairing the weakened muscle wall. Surgeons often reinforce the repair with surgical mesh to strengthen the abdominal wall and reduce recurrence.
Two main surgical approaches are open surgery and laparoscopic surgery. Open surgery involves a single, larger incision directly over the hernia site. Laparoscopic surgery is a minimally invasive technique, using several small incisions through which a camera and specialized instruments are inserted to perform the repair. Laparoscopic procedures often result in smaller scars, less pain, and faster recovery compared to open surgery. While surgery is generally recommended to prevent complications like incarceration or strangulation, very small, asymptomatic hernias might be managed with watchful waiting under medical guidance.