Incisional Hernia

What Is Incisional Hernia?

Incisional hernia occurs when the hernia protrudes through an incision made on the patient’s abdominal wall (old scar) from a previous surgical procedure. In this medical condition, internal organs (such as, the intestine) can herniate or protrude out from the abdomen, causing discomfort and a big bulge in the abdomen, especially on coughing. Pain or gangrene of the bowel can arise from an incisional hernia, which will require emergency surgery.

What Are the Causes of Incisional Hernia?

Some of the common causes of incisional hernia include:

  • Infection
  • Poor wound care
  • Poor surgical stitching and/or techniques

What Are the Risk Factors Associated with Incisional Hernia?

A previous history of abdominal surgery is the most important risk factor that may lead to an incisional hernia. Other risk factors may include:

  • Obesity
  • Pregnancy
  • Excessive pressure from hard coughing, sneezing, bowel movement, heavy lifting, straining, or overexertion
  • Smoking
  • Excessive use of steroids
  • Excessive consumption of alcohol
  • Elderly patients as older patients have a poorer healing mechanism with age

What Are The Common Symptoms Of Incisional Hernia?

The most common signs and symptoms may include discomfort and bulging near the abdominal incision. The early signs and symptoms include:

  • Abdominal pain
  • Protuberant pressure or fullness;
  • Swelling
  • Constant dull aching pain at the site of the hernia

The following are considered as signs and symptoms that require emergency surgery:

  • Nausea and vomiting
  • Fever
  • Foul smelling drainage or difficult bowel movement
  • Protrusion of internal tissues, intestine, muscle, and/or fatty contents from the fascial discontinuity
  • Visible signs of inflammation due to bowel obstruction such as red streaks (sign of infection); and,
  • Underlying symptoms caused by the strangulation of the intestines (such as bowel obstruction, digestive disorders, and jaundice).

What Are The Complications Of Incisional Hernia?

  • Evisceration of gut/ incarcerated hernia wherein the intestines become trapped outside the abdomen area and inside the hernial sac. This blocks the intestine and subsequently reduces the blood supply;
  • Strangulated hernia, which causes obstruction of the intestine as the flow of blood to the intestine gets blocked. Part of the intestine may die or start decaying due to the lack of blood supply to the intestine, which may lead to gangrene. This can be fatal, if not treated through immediate surgical intervention.

What Are The Screening Methods For Incisional Hernia?

Once a swelling, visible protrusion, or bulge is located, your doctor may suggest following tests:

  • Examining a scar or wound developed from a previous surgery to identify swelling, protrusion, or bulge
  • Blood tests
  • X-rays
  • Ultrasound or CT scan

While diagnosing the incisional hernia, your surgeon may schedule a further surgery to repair an incisional hernia (also medically termed as ventral hernia repair).

How Incisional Hernia Can Be Treated?

An incisional hernia, in general, cannot be treated or repaired by using medications. In most cases, your doctor may suggest surgery as the only viable option for treating this condition. Surgery is recommended in the following situations:

  • If the size of the hernia grows over a period of time and becomes very large
  • When the lump looks ugly and affects an individual’s aesthetic appearance
  • If the bulge is painful

The surgery may be carried out by using either via the laparoscopic method or open method under anesthesia. During the surgery, the surgeon will put the hernia back to its original position. The defect will be covered using a hernia’s mesh, thereby repairing the hernia.

If you are also affected with an incisional hernia, check with incisional hernia specialist immediately to discuss the treatment options!