Types of Hernias
There are several different types of hernias that occur in the abdomen, each of which have their own specific causes, symptoms and treatment. They are commonly named for their location in the abdomen. The most common hernias include:
Inguinal hernias form in the groin and are usually caused by weakness in the muscle around the opening of the inguinal canal. They affect men more than women by a 3-to-1 ratio. Inguinal hernias can be caused by a congenital weakness in the area (through which testicular attachments pass) or from significant strain due to heavy lifting, chronic cough, obesity or any other increase in abdominal pressure. These hernias represent the largest single reason for hernia surgery, accounting for over 800,000 such procedures every year in the US.
Femoral hernias are often visible and palpable below the inguinal crease (the thigh-side of the crease where the leg meets the abdomen) and affect women more often than men. These hernias require more urgent care as they have a higher risk (greater than 20%) of incarceration or strangulation, which would require emergency care. Femoral hernias are almost always repaired sooner rather than later.
Umbilical hernias are caused by weakness in the belly button. Every human being, as a result of the umbilical cord, has an inherent weakness at the navel. It is estimated that up to 1 in 5 children are born with umbilical hernias but these usually close within the first five years of life. Umbilical hernias in adults will not resolve – rather they will usually increase in size. These hernias may exist unknown for years and are typically found when they become symptomatic, or during routine physicals.
Incisional hernias are caused by weakness in the abdominal walls and fascia after a surgical procedure. The incision creates an inherently weak point in the abdomen which carries a higher risk of herniation at some point in the future. The larger the incision, the greater the change of a hernia. Laparoscopic surgery reduces the risk of incisional hernias by using small incisions versus a large, single incision.
Hiatal hernias are located further up in the body and represent the stomach pushing through a defect in the diaphragm. They can cause various symptoms including chronic acid reflux. These are treated somewhat differently from hernias of the abdomen and are often repaired secondary to a bariatric surgery procedure. Many of these hernias remain undiagnosed as they are often asymptomatic, or symptoms are very generalized in nature. Learn more about Hiatal Hernia Surgery.
Ventral hernias occur anywhere in the abdomen except the groin and umbilicus and represent a small proportion of all hernias.
While there are other types of hernias, they occur far more rarely and are diagnosed on a case-by-case basis, either by physical exam or imaging if necessary.