Abdominal Hernias Questions & Answers

Updated: Jul 23, 2019
  • Author: Assar A Rather, MBBS, MD, FACS; Chief Editor: John Geibel, MD, MSc, DSc, AGAF  more...
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Questions & Answers

Overview

What are abdominal hernias?

How are abdominal hernias detected?

What are the characteristics of asymptomatic abdominal hernias?

What are the characteristics of incarcerated abdominal hernias?

What are characteristics of strangulated abdominal hernias?

How are abdominal hernias identified?

What are characteristics of different types of abdominal hernias?

How are abdominal hernias diagnosed?

Which lab studies are used in the diagnosis of abdominal hernias?

Which imaging studies are used in the diagnosis of abdominal hernias?

What is the medical treatment for abdominal hernias?

What are the surgical treatment options for inguinal hernias?

What are the surgical treatment options for different types of abdominal hernias?

How common are abdominal hernias?

What is an abdominal hernia?

How is omphalocele differentiated from gastroschisis in congenital abdominal hernias?

What is the anatomy of the anterior abdominal wall in relation to abdominal hernias?

What is the anatomy of the paired rectus abdominis muscles in relation to abdominal hernias?

What are the anatomic features of the anterior and posterior laminae in relation to abdominal hernias?

What are the anatomic features of the external oblique muscles in relation to abdominal hernias?

What are the anatomic features of the transversus abdominis in relation to abdominal hernias?

What are the anatomic features of the caudad margin in relation to abdominal hernias?

What are the anatomic features of the innominate and transversalis fasciae in relation to abdominal hernias?

What are the anatomic features of the posterolateral (lumbar) region in relation to abdominal hernias?

What is the anatomy of the serratus posterior inferior in relation to abdominal hernias?

What is the anatomy of the latissimus dorsi in relation to abdominal hernias?

What are the anatomic features of the superior lumbar triangle of Grynfeltt-Lesshaft in relation to abdominal hernias?

What is the inferior lumbar triangle of Petit relative to abdominal hernias?

What is the anatomy of the blood vessels involved in abdominal hernias?

What is the anatomy of the inguinal ligament involved in abdominal hernias?

What is the anatomy of the transversus abdominis in abdominal hernias?

What is the anatomy of the pectineal ligament involved in abdominal hernias?

What is the anatomy of the aponeurotic band in relation to abdominal hernias?

What is the anatomy of the iliacus fascia in relation to abdominal hernias?

What is the anatomy of the femoral sheath in relation to abdominal hernias?

What is the anatomy of the borders of the Hesselbach triangle in relation to abdominal hernias?

What are the anatomic features of the transversalis fascia and transversus abdominis in abdominal hernias?

What is the anatomic role of male reproductive parts in abdominal hernias?

What is the anatomy of the inferior epigastric artery in relation to abdominal hernias?

What is the anatomy of the iliohypogastric and ilioinguinal nerves in relation to abdominal hernias?

What is the anatomy of the umbilical ligaments in relation to abdominal hernias?

What are the anatomic features of the internal inguinal ring involved in abdominal hernias?

What is the anatomy of the obturator internus in relation to abdominal hernias?

What is the anatomy of the obturator canal in relation to abdominal hernias?

What is the pathophysiology of abdominal inguinal hernias?

What is the role of stress in the development of abdominal inguinal hernias?

What are some conditions associated with an increased incidence of abdominal inguinal hernias?

How does acquired elastase deficiency lead to increased incidence of abdominal hernias?

What is a direct inguinal hernia?

What is an indirect inguinal hernia?

What is the pathophysiology of a femoral hernia?

What is the pathophysiology of an abdominal umbilical hernia?

Which conditions should be considered in children with abdominal umbilical hernias?

What is the pathophysiology of an abdominal Richter hernia?

What is the pathophysiology of an abdominal incisional hernia?

What is the pathophysiology of an abdominal spigelian hernia?

What are the types of abdominal spigelian hernias?

What is the pathophysiology of an abdominal obturator hernia in relation to abdominal hernias?

What causes different types of abdominal hernias?

What are the embryogenic factors in omphalocele and gastroschisis in congenital abdominal hernias?

What anomalies are associated with improper development of portions of the abdominal wall in abdominal hernias?

What are the clinical manifestations of maldevelopment of the interior (caudal) fold in abdominal hernias?

What are the clinical manifestations of maldevelopment of the lateral fold in abdominal hernias?

What is an omphalocele-exstrophy-imperforate anus-spinal defects (OEIS) complex in abdominal hernias?

What is the correlation between maternal smoking and abdominal hernias?

What is gastroschisis and how does it occur?

What causes an indirect inguinal abdominal hernia?

How does a congenital abdominal hernia develop during the first trimester?

How does a congenital abdominal hernia develop in a male fetus?

What is the embryonic difference in the development of the inguinal canal between males and females?

What is the embryonic development of gonads and how does the process contribute to the abdominal hernias?

What increases intra-abdominal pressure and may cause an abdominal hernia?

How common are abdominal hernias in the US?

What is the incidence of omphalocele and gastroschisis in the US?

How common are abdominal hernias in developing countries?

How is the prevalence of abdominal hernias affected by age?

What are the age-related demographics for abdominal inguinal hernias?

How common are abdominal umbilical hernias?

Which types of abdominal hernias are most common in older women?

What are the age-related demographics for incarcerated or strangulated abdominal hernias?

What are the sex-related demographics for abdominal inguinal hernias?

What are the sex-related demographics for abdominal sliding hernias?

What are the sex-related demographics for abdominal femoral hernias?

What are the sex-related demographics for abdominal epigastric and internal supravesical hernias?

What are the race-related demographics for abdominal umbilical hernias?

What are the prognostic factors in abdominal hernias?

What bowel complications are associated with abdominal hernias?

What is the mortality rate for abdominal inguinal hernias?

What are the surgical complications and recurrence rates for abdominal inguinal hernias?

What are potential complications of abdominal inguinal hernia repair?

What causes postoperative death in patients with abdominal inguinal hernias?

What postoperative complications are associated with abdominal inguinal hernia repair?

What is the recurrence rate for abdominal hernias?

What are the technical factors that increase the likelihood of recurrence of abdominal inguinal hernias?

What are the potential complications and recurrence rate for noninguinal abdominal hernias?

Which complications are associated with gastroschisis and omphalocele (abdominal hernias)?

What is the infant mortality rate for gastroschisis or omphalocele (abdominal hernias)?

How common is intestinal atresia in patients with gastroschisis (abdominal hernia)?

When is antireflux medication indicated for the treatment of gastroschisis and omphalocele (abdominal hernias)?

What is the long-term outcome of gastroschisis and omphalocele (abdominal hernias)?

What educational information should be provided to patients with abdominal hernias?

Presentation

What is the clinical presentation of an abdominal hernia?

What are the characteristics of an asymptomatic abdominal hernia?

What are the symptoms of an abdominal hernia?

What are the symptoms of an incarcerated abdominal hernia?

What are the symptoms of a strangulated abdominal hernia?

What is the significance of pain associated with an abdominal hernia?

Which symptoms are associated with different types of abdominal hernias?

How is a physical exam performed on a patient with suspected abdominal hernia?

How is an abdominal hernia identified?

What are the physical findings that distinguish direct and indirect abdominal hernias?

How are strangulated and incarcerated abdominal hernias differentiated?

How is a physical exam performed on an adult patient with an abdominal inguinal hernia?

How is a physical exam performed on a child with an abdominal inguinal hernia?

What are the physical findings in sliding inguinal abdominal hernias?

What are the physical findings that distinguish different types of abdominal hernias?

What are the physical findings associated with incarcerated abdominal hernias?

What are the physical findings of a hydrocele in an abdominal hernia?

When is treatment not indicated for a hydrocele?

What are the clinical findings of hydroceles in children with abdominal hernias?

What is an abdominoscrotal hydrocele?

What is the relationship between abdominal hernias and intestinal obstruction?

What are the clinical presentations of abdominal spigelian hernias?

When is a testicular tumor considered in the evaluation of an abdominal hernia?

What is the differential diagnosis of a groin mass inferior to the inguinal ligament and medial to the femoral vessels in the diagnosis of an abdominal hernia?

Which clinical findings suggest an incarcerated abdominal femoral hernia?

How is cat-scratch disease lymphadenitis differentiated from an abdominal inguinal hernia?

Which infections can cause inguinofemoral adenopathy which may be mistaken for an abdominal inguinal hernia?

How are the different types of abdominal femoral hernias differentiated?

What are the clinical characteristics of abdominal obturator hernias?

What is the clinical presentation of abdominal sciatic and perineal hernias?

What is the clinical presentation of abdominal umbilical hernias?

What is the relationship between diastasis recti and abdominal hernias?

What is the difference between umbilical granuloma and umbilical polyps in abdominal hernias?

How are abdominal wall defects in fetuses detected?

When are abdominal hernias identified in neonates?

DDX

Which conditions associated with abdominal hernias should be assessed in the history and physical exam?

What are the differential diagnoses for Abdominal Hernias?

Workup

Which diagnostic techniques are recommended in the workup of abdominal hernias?

Which provocative factors should be evaluated in the workup of abdominal hernias?

Which lab studies are used in the workup of abdominal hernias?

What is the role of plain radiographs in the diagnosis of abdominal hernias?

What is the role of nonionic contrast in the imaging workup of abdominal hernias?

Which imaging studies may be helpful in the diagnosis of incarcerated or strangulated abdominal hernias?

What is the role of CT scanning in the diagnosis of abdominal hernias?

What is the role of ultrasonography in the diagnosis of abdominal hernias?

What are the histologic findings in pediatric abdominal hernias?

Treatment

What is the purpose of binders or corsets in the treatment of abdominal hernias?

When should a surgeon be consulted for repair of an abdominal hernia?

What are the treatment approaches for abdominal inguinal hernias?

When is abdominal umbilical hernia repair indicated?

When should an abdominal umbilical hernia be repaired in young children?

What is the importance of the size of the fascial defect in the repair of abdominal umbilical hernias?

How common are incarcerated abdominal umbilical hernias?

Which types of abdominal hernias should be repaired due to the risk of incarceration?

What are the indications for elective and acute repair of abdominal hernias?

How is an abdominal hernia reduced?

How is an abdominal hernia reduction modified in young children and infants?

What treatment is indicated if reduction of an abdominal hernia is not successful?

What are the elements of the spontaneous reduction technique in the treatment of an abdominal hernia?

What is the role of silver nitrate in the treatment of umbilical granuloma associated with an abdominal hernia?

What risks are associated with topical treatments for omphalocele (abdominal hernia)?

How is progressive compression dressing used in the treatment of an omphalocele sac (abdominal hernia)?

When are topical medications and abdominal wrapping indicated in the treatment of an omphalocele (abdominal hernia)?

What are the options for delayed fascial closure in the treatment of an omphalocele (abdominal hernia)?

What are the fundamentals of indirect inguinal hernia repair?

When can patients who’ve had surgical repair of abdominal inguinal hernia return to work?

What are the Bassini and Shouldice repair techniques for the surgical treatment of abdominal inguinal hernias?

What is the Cooper repair for the surgical treatment of abdominal inguinal hernias?

How is mesh used in the repair of abdominal inguinal hernias?

How effective is the peritoneal approach for tension-free mesh repair of an abdominal inguinal hernia?

How is the preperitoneal approach performed in the surgical repair of abdominal inguinal hernias?

How are simple inguinal hernias repaired in children?

How is the fascia repaired in simple inguinal abdominal hernia repair in children?

How is intersex differentiation syndrome investigated in girls with abdominal inguinal hernias?

What is the most common cause of intersex differentiation syndrome in girls with abdominal inguinal hernias?

What are the characteristics of an incarcerated ovary in an abdominal inguinal hernia?

When is immediate surgical repair indicated in pediatric abdominal inguinal hernia?

How is the surgical procedure performed for the treatment of abdominal inguinal hernias in children?

What are the laparoscopic techniques used in the surgical treatment of abdominal inguinal hernias?

What are the benefits and drawbacks of laparoscopic procedures for the surgical treatment of abdominal inguinal hernias?

What information should be provided to adult patients prior to surgical treatment abdominal inguinal hernias?

What is the purpose of prosthetic material in the surgical treatment of adults with abdominal inguinal hernias?

What are the treatment approaches for adults with very large chronic abdominal inguinal hernias?

Is preoperative antibiotic prophylaxis indicated in adults with abdominal inguinal hernias?

What is the role of neurectomy in adults with abdominal inguinal hernias?

What are the treatment approaches for neonates with abdominal inguinal hernias?

What are the treatment approaches for premature infants with abdominal inguinal hernias?

What are the treatment approaches for children with bilateral abdominal inguinal hernias?

What is the role of peritoneoscopy in the surgical treatment of abdominal inguinal hernias in children?

Which providers should not perform surgical repair of abdominal inguinal hernias in children?

Are perioperative antibiotics indicated in the surgical treatment of abdominal inguinal hernias in children?

Is abdominal inguinal hernia repair an outpatient procedure in premature infants and neonates?

What is the surgical treatment for an abdominal sliding hernia?

What is the treatment for atypical tuberculous adenitis in patients with abdominal hernias?

How are abdominal umbilical hernias repaired in children?

What is the role of cosmesis in the surgical repair of abdominal umbilical hernias in children?

How is an abdominal epigastric hernia surgically repaired?

How is an abdominal spigelian hernia surgically repaired?

How is an abdominal interparietal hernia surgically repaired?

How is an abdominal supravesical hernia surgically repaired?

What is the surgical approach in the repair of an abdominal lumbar hernia?

What is the surgical approach in the repair of an abdominal obturator hernia?

When is the transperitoneal approach indicated in the surgical repair of an abdominal sciatic hernia?

When is the transgluteal approach indicated in the surgical repair of an abdominal sciatic hernia?

Which surgical approach is preferred in the repair of an abdominal perineal hernia?

Why have the outcomes of abdominal hernia repair in children improved over the years?

Why has there been modest progress in mortality rates in patients with syndromic omphaloceles?

What are the considerations in the delivery and early perioperative care of neonates with abdominal wall defects?

What are the major challenges in the treatment of gastroschisis and omphaloceles?

What is the best treatment approach for omphalocele and gastroschisis?

What is the nonoperative management strategy for gastroschisis?

Why are intra-abdominal pressure measurements important in neonates with abdominal wall hernias?

What is the role of abdominal binding in the treatment of omphaloceles?

How is intestinal atresia managed in the treatment of abdominal wall hernias?

When should Beckwith-Wiedemann syndrome be suspected in neonates with abdominal hernias?

How are malformations of abdominal folds characterized in the treatment of abdominal hernias?

How are umbilical remnants managed in in the treatment of abdominal hernias in neonates?

What is involved in the long-term monitoring of abdominal hernias?

Medications

When are antibiotics indicated in the treatment of abdominal hernias?

Which medications in the drug class Analgesics are used in the treatment of Abdominal Hernias?

Which medications in the drug class Nonsteroidal Anti-Inflammatory Drugs (NSAIDs) are used in the treatment of Abdominal Hernias?

Which medications in the drug class Antianxiety Agents are used in the treatment of Abdominal Hernias?

Which medications in the drug class General Anesthetics are used in the treatment of Abdominal Hernias?

Which medications in the drug class Local Anesthetics are used in the treatment of Abdominal Hernias?

Which medications in the drug class Antibiotics are used in the treatment of Abdominal Hernias?