A hernia is an abnormal protrusion of an organ into the walls of its containing cavity. Broadly, hernia can be described as external hernia and internal hernia. While external hernia can be seen and palpated on the skin surface, internal hernia are not visible or cannot be palpated from outside.
Internal hernias are most common within the abdominal cavity. Internal hernia occurs when a portion of one organ pushes into the opening in the wall of another organ within the abdominal cavity. Internal hernia is rare and it is not detected easily until the condition produces pain, obstruction and strangulation.
Internal hernia is a diagnostic challenge as clinical examination may not reveal any bulge on the body surface. Only CT scan or MRI may help to detect it if suspected. Internal hernia needs immediate medical attention because of the risk of strangulation and gangrene of the affected part.
What Causes An Internal Hernia?
If you know better of how an external hernia develops, it becomes easier to understand the development of internal hernia. External hernia develops when a part of an organ protrudes in the opening or weak point in the wall of abdomen.The most common examples of external hernia are inguinal hernia and umbilical hernia. The bulge can be felt and palpated on the skin surface. But in internal hernia a part of an organ pushes itself into the weak point of the wall or opening of another organ.
Internal hernias are not brought about by straining or pressure at the weak spot of abdominal wall. It occurs due to an opening in another adjacent organ. This opening can develop as a result of an injury, after a surgery (example gastric bypass surgery) or it can be a congenital opening. However, pressure in the abdominal cavity can worsen the symptoms of internal hernia. Internal hernia usually occurs in adulthood, despite of its congenital origin. Its occurrence is more in men than women.
Symptoms Of Internal Hernia
\Internal hernia is often missed as the symptoms remain undetected for most of the time, until it begins to pain. Pain in abdomen which may wax and wane from time to time may be a symptom of internal hernia, especially if there is a past history of abdominal surgery such as gastric bypass. There is no visible bulge under the skin which is a common finding in external hernia such as umbilical hernia.
Nausea and vomiting are common findings when small bowel is obstructed. Patient frequently vomits with pain in abdomen. The abdomen becomes enlarged and is filled with gasses due to obstruction.
Diagnosing internal hernia is difficult as the symptoms are often mild and remain silent for most of the time, unless the intestine gets obstructed and strangulated. CT scan and MRI are useful in detecting the condition. Sometimes exploratory surgery may only reveal internal hernia.
How To Repair Internal Hernia?
Internal hernia requires to be treated urgently in majority of cases once it is diagnosed. The mortality rate increases when the intestine is strangulated and obstructed. Though surgery is found to be effective in repairing the defect, in some cases recurrence is possible if the tissues are weak.
Internal hernia can be repaired with a laproscope. A cut is made under the umbilicus and the abdomen is inflated for better visual surveillance of the organs. Laproscopic instruments are inserted through the hole and the obstructed bowel is reduced and the defect is closed with sutures.
Patient should follow healthy lifestyle after the surgery.