Table Of Contents
Incisional hernia
An incisional hernia is the herniation of abdominal contents through a “healed” surgical incision. A complication of abdominal surgery. Dx is clinical. It is not the same as wound evisceration (where abdominal contents are completely expelled without a lining or sac), which would be a surgical EMERGENCY!
Occurs in 5-10% of incisions
- Risk factors
- Midline incision
- Post-op incision site infection
- Post-op incision site hematoma
- Malnutrition
- Poor suturing technique
- Anything that causes increased intra-abdominal pressure
- Treatment
- Herniorrhaphy after the pt has recovered from the initial surgery
Umbilical hernia
An umbilical hernia is a protrusion of intra-abdominal contents through the navel. Almost always due to a congenital defect. Almost always occurs in kids. It can be acquired in patients with long-term increased intra-abdominal pressure, especially ascites. Can see in adults who weren’t treated as young adults.
3X more common in males than in females. Regress by 3 years of age 95% of the time.
- Differentials
- Periumbilical hernia: Herniation through the abdominal wall around it
- Omphalocele: abdominal contensts outside the abdomen in a shiny sac (peritoneum)
- Treatment
- Herniorrhaphy (in adults and children over 3 years of age or with complications)
- Complications
- Incarceration
- Strangulation SBO
