What is Ventral Hernia

Ventral hernia is a bulge of tissue from inside the abdomen that pushes through a weak area of the muscles that form the front wall of the abdomen. The tissues inside the abdomen are inside a sac (peritoneum). These tissues include the small intestine, large intestine, and the fatty tissue that covers the intestines (omentum). Sometimes, the bulge that forms a hernia contains intestines. Other hernias contain only fat. Ventral hernias do not go away without surgical treatment.

There are several types of ventral hernias. You may have:

• A hernia at an incision site from previous abdominal surgery (incisional hernia).
• A hernia just above the belly button (epigastric hernia), or at the belly button (umbilical hernia). These types of hernias can develop from heavy lifting or straining.
• A hernia that comes and goes (reducible hernia). It may be visible only when you lift or strain. This type of hernia can be pushed back into the abdomen (reduced).
• A hernia that traps abdominal tissue inside the hernia (incarcerated hernia). This type of hernia does not reduce.
• A hernia that cuts off blood flow to the tissues inside the hernia (strangulated hernia). The tissues can start to die if this happens. This is a very painful bulge that cannot be reduced. A strangulated hernia is a medical emergency.

What are the causes?

This condition is caused by abdominal tissue putting pressure on an area of weakness in the abdominal muscles.

What increases the risk?

The following factors may make you more likely to develop this condition:

• Being male.
• Being 60 or older.
• Being overweight or obese.
• Having had previous abdominal surgery, especially if there was an infection after surgery.
• Having had an injury to the abdominal wall.
• Having had several pregnancies.
• Having a buildup of fluid inside the abdomen (ascites).

What are the signs or symptoms?

The only symptom of a ventral hernia may be a painless bulge in the abdomen. A reducible hernia may be visible only when you strain, cough, or lift. Other symptoms may include:

• Dull pain.
• A feeling of pressure.

Signs and symptoms of a strangulated hernia may include:

• Increasing pain.
• Nausea and vomiting.
• Pain when pressing on the hernia.
• The skin over the hernia turning red or purple.
• Constipation.
• Blood in the stool (feces).

How is this diagnosed?

This condition may be diagnosed based on:

• Your symptoms.
• Your medical history.
• A physical exam. You may be asked to cough or strain while standing. These actions increase the pressure inside your abdomen and force the hernia through the opening in your muscles. Your health care provider may try to reduce the hernia by pressing on it.
• Imaging studies, such as an ultrasound or CT scan.

How is this treated?

This condition is treated with surgery. If you have a strangulated hernia, surgery is done as soon as possible. If your hernia is small and not incarcerated, you may be asked to lose some weight before surgery.

Follow these instructions at home:

• Follow instructions from your health care provider about eating or drinking restrictions.
• If you are overweight, your health care provider may recommend that you increase your activity level and eat a healthier diet.
• Do not lift anything that is heavier than 10 lb (4.5 kg).
• Return to your normal activities as told by your health care provider. Ask your health care provider what activities are safe for you. You may need to avoid activities that increase pressure on your hernia.
• Take over-the-counter and prescription medicines only as told by your health care provider.
• Keep all follow-up visits as told by your health care provider. This is important.

Contact a health care provider if:

• Your hernia gets larger.
• Your hernia becomes painful.

Get help right away if:

• Your hernia becomes increasingly painful.
• You have pain along with any of the following:
  • Changes in skin color in the area of the hernia.
  • Nausea.
  • Vomiting.
  • Fever.

Summary

• A ventral hernia is a bulge of tissue from inside the abdomen that pushes through a weak area of the muscles that form the front wall of the abdomen.
• This condition is treated with surgery, which may be urgent depending on your hernia.
• Do not lift anything that is heavier than 10 lb (4.5 kg), and follow activity instructions from your health care provider.