A hernia is a bulge or jutting of viscera (internal organ of the body) through an abnormal opening in the wall that contains it. Hernia can occur in any part of the body, but generally abdominal and inguinal hernias are common. It can be congenital or acquired later in life.
Ventral hernia is an abdominal hernia. In ventral hernia, a part of intestine projects out through an abnormal opening of the abdominal wall. This abnormal opening is created as a result of weakness of the abdominal muscles, or a tear in the abdominal wall.
The cause is previous abdominal surgery. Therefore ventral hernia is also called incisional hernia. Sometimes ventral hernia can also occur as a result of abdominal injury or a birth defect. Incisional or ventral hernia accounts for at least 5 percent of all the hernias.
What Causes A Ventral Hernia?
Ventral hernia can develop due to many reasons. They can develop since birth or later in life.
- Weakness of abdominal wall is one of the reasons for ventral hernia.
- Congenital hernia develops when the abdominal wall remains incompletely closed. Umbilicus hernia is an example.
- Ventral hernia after abdominal surgery most often develops in obese individuals, those patients who have post operative persistent cough, or post operative abdominal distension.
- There is high incidence of ventral hernia following an infected surgical wound.
- Formation of a huge blood clot at the site of surgical incision can strain the sutures which can give rise to hernia later on.
- In a malnourished patient, it may take time for healing of surgical wound. This may be a triggering cause for ventral hernia.
- Tearing of postoperative stitches due to strain can be a reason for hernia formation.
Symptoms Of Ventral Hernia
Generally, ventral hernia starts as a symptomless after an abdominal surgery immediately or very early post operative period. It is erroneous concept that ventral hernia occurs during late convalescence period. If the surgical wound is healed properly, the scar tissue is able to withstand the buffeting of any walk of life, this also include pregnancy.
Following are some of the symptoms:
Bulge under abdominal skin is the most common symptom the patient first notices. This protrusion becomes prominent while coughing, lifting heavy weight, laughing, etc. The patient is able to push back the bulge with gentle pressure or the bulge reduces when the patient lies down.
Hernia becomes painful and tender when intestinal bulge gets obstructed or strangulated. This gives rise to symptoms such as vomiting, and nausea together with pain. Sometimes the skin overlying it is so thin that normal intestinal movement can be seen. If there is obstruction and strangulation of the hernia, heart rate increases and patient appears sick.
Treatment Options For Ventral Hernia
If ventral hernia is asymptomatic and small bulge is present, patient can take self care at home. This includes drinking enough quantity of water and eating high fiber food. Also reducing weight, exercising lightly, and quit smoking.
- Support to the abdominal wall with a special belt called truss can prevent the bulging of hernia.
- Avoid lifting heavy weight.
- Patient should avoid constipation.
- Practice yoga exercise such as Suryanamaskar. It is a type of bending exercise which makes the abdominal muscles strong.
All these are palliative treatment. They do not cure hernia. The only effective cure is surgery. There are many instances where recurrence of hernia is common. In order to obtain a lasting repair, very special care need to be taken. The patient has to take steps to reduce his weight if he is obese. Surgery for hernia is called hernioplasty.