What is a ventral hernia?

A hernia occurs when there is a hole in the muscles of the abdominal wall, allowing a loop of intestine or abdominal tissue to push through the muscle layer. A ventral hernia is a hernia that occurs at any location along the midline (vertical center) of the abdomen wall. There are three types of ventral hernia:

Epigastric (stomach area) hernia. This hernia occurs anywhere from just below the breastbone to the navel (belly button). This type of hernia is seen in both men and women.

Umbilical (belly button) hernia. This hernia occurs in the area of the belly button.

Incisional hernia. This hernia develops at the site of a previous surgery. Up to one-third of patients who have had an abdominal surgery will develop an incisional hernia at the site of their scar. This type of hernia can occur anytime from months to years after an abdominal surgery.

What are the causes and risk factors for developing a ventral hernia?

There are many causes including:

  • Weakness at the incision site of a previous abdominal surgery (which could result from an infection at the surgery site or failed surgical repair/mesh placement).
  • Weakness in an area of the abdominal wall that was present at birth.
  • Weakness in the abdominal wall caused by conditions that put strain on the wall. These include:
    • Being overweight
    • Frequent coughing episodes
    • Severe vomiting
    • Pregnancy
    • History of lifting or pushing heavy objects
    • Straining while having a bowel movement/urinating
    • Injuries to the bowel area
    • Lung diseases (chronic obstructive pulmonary disease and emphysema; struggling to breathe puts strain on the abdominal wall)
    • Prostatism (enlargement of the prostate gland, which causes straining while urinating in older men)
    • Older age (general loss of elasticity to abdominal wall)

What are the signs and symptoms of a ventral hernia?

Some patients don’t feel any discomfort in the early stages of ventral hernia formation. Often, the first sign is a visible bulge under the skin in the abdomen or an area that is tender to the touch. The bulge may flatten when lying down or pushing against it.

A ventral hernia causes an increasing level of pain when a person:

  • Lifts heavy objects
  • Strains to have a bowel movement/urinate
  • Sits or stands for long periods of time

Severe abdominal pain can occur if part of the intestine bulges through the abdominal wall and becomes trapped in the opening. If this happens, the trapped portion of the intestine becomes strangled, loses its blood supply, and starts to die. This is a medical emergency that requires immediate care.

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