Overview of abdominal wall hernias in adults
- David C Brooks, MD
David C Brooks, MD
- Associate Professor of Surgery
- Harvard Medical School
A hernia is a protrusion, bulge, or projection of an organ or part of an organ through the body wall that normally contains it, such as the abdominal wall. They are typically classified by etiology and location. Most abdominal wall hernias should be repaired when identified; however, there are exceptions (eg, parastomal hernia). The nature of the repair depends upon the size of the hernia and the location on the abdominal wall in which it has occurred.
An overview of the classification, clinical features, and treatment options for most abdominal wall hernias will be reviewed here. More in-depth information for incisional hernias, inguinal and femoral hernias, parastomal hernias, and hernias related to peritoneal dialysis are discussed separately.
●(See "Incisional hernia".)
●(See "Parastomal hernia".)
- Steinke W, Zellweger R. Richter's hernia and Sir Frederick Treves: an original clinical experience, review, and historical overview. Ann Surg 2000; 232:710.
- Kadirov S, Sayfan J, Friedman S, Orda R. Richter's hernia--a surgical pitfall. J Am Coll Surg 1996; 182:60.
- Murphy KP, O'Connor OJ, Maher MM. Adult abdominal hernias. AJR Am J Roentgenol 2014; 202:W506.
- Ranney B. Diastasis recti and umbilical hernia causes, recognition and repair. S D J Med 1990; 43:5.
- Lang B, Lau H, Lee F. Epigastric hernia and its etiology. Hernia 2002; 6:148.
- Mudge M, Hughes LE. Incisional hernia: a 10 year prospective study of incidence and attitudes. Br J Surg 1985; 72:70.
- Kingsnorth A, LeBlanc K. Hernias: inguinal and incisional. Lancet 2003; 362:1561.
- Bucknall TE, Cox PJ, Ellis H. Burst abdomen and incisional hernia: a prospective study of 1129 major laparotomies. Br Med J (Clin Res Ed) 1982; 284:931.
- George CD, Ellis H. The results of incisional hernia repair: a twelve year review. Ann R Coll Surg Engl 1986; 68:185.
- van Ramshorst GH, Nieuwenhuizen J, Hop WC, et al. Abdominal wound dehiscence in adults: development and validation of a risk model. World J Surg 2010; 34:20.
- Fassiadis N, Roidl M, Hennig M, et al. Randomized clinical trial of vertical or transverse laparotomy for abdominal aortic aneurysm repair. Br J Surg 2005; 92:1208.
- Fitzgibbons RJ Jr, Giobbie-Hurder A, Gibbs JO, et al. Watchful waiting vs repair of inguinal hernia in minimally symptomatic men: a randomized clinical trial. JAMA 2006; 295:285.
- Moreno-Egea A, Baena EG, Calle MC, et al. Controversies in the current management of lumbar hernias. Arch Surg 2007; 142:82.
- Orcutt TW. Hernia of the superior lumbar triangle. Ann Surg 1971; 173:294.
- Salameh JR. Primary and unusual abdominal wall hernias. Surg Clin North Am 2008; 88:45.
- Stamatiou D, Skandalakis LJ, Zoras O, Mirilas P. Obturator hernia revisited: surgical anatomy, embryology, diagnosis, and technique of repair. Am Surg 2011; 77:1147.
- Losanoff JE, Basson MD, Gruber SA, Weaver DW. Sciatic hernia: a comprehensive review of the world literature (1900-2008). Am J Surg 2010; 199:52.
- Skandalakis PN, Zoras O, Skandalakis JE, Mirilas P. Spigelian hernia: surgical anatomy, embryology, and technique of repair. Am Surg 2006; 72:42.
- Mufid MM, Abu-Yousef MM, Kakish ME, et al. Spigelian hernia: diagnosis by high-resolution real-time sonography. J Ultrasound Med 1997; 16:183.
- Shenouda NF, Hyams BB, Rosenbloom MB. Evaluation of Spigelian hernia by CT. J Comput Assist Tomogr 1990; 14:777.
- Larson DW, Farley DR. Spigelian hernias: repair and outcome for 81 patients. World J Surg 2002; 26:1277.
- Moreno-Egea A, Carrasco L, Girela E, et al. Open vs laparoscopic repair of spigelian hernia: a prospective randomized trial. Arch Surg 2002; 137:1266.
- Halm JA, Heisterkamp J, Veen HF, Weidema WF. Long-term follow-up after umbilical hernia repair: are there risk factors for recurrence after simple and mesh repair. Hernia 2005; 9:334.
- CLINICAL FEATURES
- Physical findings
- DIFFERENTIAL DIAGNOSIS
- SPECIFIC HERNIA SITES
- Epigastric hernia
- Incisional hernia
- Inguinal and femoral hernia
- Lumbar hernia
- Obturator hernia
- Parastomal hernia
- Perineal hernia
- Sciatic hernia
- Spigelian hernia
- Umbilical hernia
- INFORMATION FOR PATIENTS
- SUMMARY AND RECOMMENDATIONS