The Latin word ‘hernia’ literally means a rupture, and in medical terminology a hernia refers to complications arising from a hole or rupture in the muscle wall of the chest and abdomen where internal organs protrude through the muscle wall.
They are more common in men than in women, with around 25% of men developing a hernia in the groin at some point in their life, whereas only 3% of women develop groin hernias.
In some cases the protrusion can actually be gently pushed back into the body cavity by a doctor (this is called a ‘reducible hernia’) but in more serious cases the protrusion cannot be pushed back in (a ‘non reducible hernia’) and can become strangulated and infected. Both types of hernia are best treated by hernia repair surgery.
Hernias can form in different parts of the muscle wall for a variety of different reasons and are given names specific to their locations and causations (see below). Some hernias are mainly congenital in nature, some are induced by lifestyle changes in the body such as putting on weight and weakening of the abdominal muscles with age, and some are caused by accident or injury. Hernias in the groin are for example most common in babies under one year of age and in people older than fifty.
Various types of hernia are more common in one sex than in another, largely down to internal body makeup differences.
Here are the most common types of hernias.
An Inguinal Hernia is one where a congenital (i.e. inherited) weakness in the muscles of the abdomen in the groin area allow a hernia to develop. Although more common in men than in women, inguinal hernias are the most common type in both sexes. They are very common in middle age.
Femoral hernias describe those hernias that protrude from the floor of the abdomen down into the leg at the top of the thigh in the groin area. This type of hernia is more common in women than in men.
There is often a weakness in the abdominal muscles near the navel, and hernias that occur here are referred to as umbilical hernias.
These are hernias that are caused by incomplete healing of surgical scars after a surgical procedure.
Diaphragmatic (Hiatus) Hernia
A Hiatus Hernia forms when a section of the oesophagus and stomach protrudes through a gap in the diaphragm, the muscle that sits below the lungs and allows breathing. This gap is there to allow the oesophagus to connect down to the stomach, but is the weakest section of the muscle. Hiatus hernias are the second most common type of hernia after inguinal hernias.
Surgery is the only treatment for most types of hernia. Some hernias, especially non reducible hernias, require immediate surgery.
Today hernias can be operated on either using conventional surgery or using keyhole surgery techniques. There are also two types of repair surgery, the conventional ‘tension suture’ approach where the ruptured muscles are effectively sewn back together, and a newer approach where a small piece of medical mesh is inserted into the hernia. The advantage of the new mesh technique is that the area where the hernia was is less susceptible to coming apart again due to straining, which is a risk with the conventional approach.