Inguinal Hernia

What is an inguinal hernia?
An inguinal hernia is an abnormal bulge, or protrusion, that can be seen and felt in the groin area (the area between the abdomen and the thigh). An inguinal hernia develops when a portion of an internal organ such as the intestine, along with fluid, bulges through a weakened area in the muscle wall of the abdomen.

Who is at risk for an inguinal hernia?
Some people, especially men, are born with a weakness in their groin muscles. Ninety percent of the newborns who have inguinal hernias are boys. With or without this weakness, an inguinal hernia can be caused by increasing pressure in the abdomen. Risk factors include:

What are the symptoms of inguinal hernia?
Inguinal hernias are characterized by pain in the groin area when coughing, sneezing, or lifting. Some people may notice a slight bulge or protrusion in the groin area that can be pushed back in. Other symptoms include constipation and blood in the stool. 

How is an inguinal hernia diagnosed?
A physician's physical examination is often enough to diagnose a hernia. Sometimes hernia swelling is visible when you stand upright. Usually, the hernia can be felt if you place your hand directly over it and then bear down. Ultrasound may be used to see certain types of hernias, and abdominal X-rays may be ordered to identify a bowel obstruction. 

How is an inguinal hernia treated?
If the hernia bulge can be pushed back in and the symptoms are tolerable, you may not need surgery. Your physician may suggest that you wear a special belt to support the area, and avoid heavy lifting.

If the inguinal hernia symptoms are painful, the treatment is elective surgery. The surgery to correct the condition is performed under a local or general anesthesia, either on an outpatient basis or in the hospital. The surgery, called herniorrhaphy, repairs the opening in the muscle wall. Inguinal herniorrhaphy is performed using a laparoscope, a thin, telescope-like instrument that requires a small incision and involves a short recovery time.

During laparoscopic surgery, five or six small (5 to 10 millimeter) incisions are made in the abdomen. The laparoscope and surgical instruments are inserted through these incisions. The surgeon is guided by the laparoscope, which transmits a picture of the internal organs on a monitor. The advantages of laparoscopic surgery include smaller incisions, less risk of infection, less pain and scarring, and a more rapid recovery.

Sometimes the weak area is reinforced with steel mesh or wire. This operation is called hernioplasty.

Incarcerated and strangulated hernias
If the weakness in the abdominal wall is small to moderate in size, a portion of intestine may get trapped, or incarcerated. This is called an incarcerated hernia and can cause problems such as severe pain, nausea, vomiting, or absence of bowel movements.

If the intestine becomes incarcerated or trapped in the abdominal wall defect, blood flow to the intestines may become blocked. This is called a strangulated hernia. This type of hernia is often painful and requires prompt surgery.

Surgery may be needed to remove part of the intestine if the hernia is incarcerated or strangulated. This surgery is called bowel resection. (Bowel is another word for intestine.) Bowel resection can also be performed laparoscopically.

Recovering from surgery
Many patients are able to walk around the day after hernia surgery. Generally, there are no dietary restrictions and the patient can resume his or her regular activities within a week. Complete recovery will take three to four weeks, and hard labor and heavy lifting should be avoided for at least three months after surgery. Surgery is no guarantee that your hernia will not return, so preventive measures are especially important to avoid a recurrence.

How can I prevent an inguinal hernia?

When should I call the doctor?
If you have been diagnosed with a hernia, and you have the following symptoms--nausea, vomiting, unable to have a bowel movement, or pass gas--you may have a strangulated hernia or an obstruction. These are medical emergencies. Call your doctor immediately. 

Copyright 1995-2005 The Cleveland Clinic Foundation. All rights reserved

 

This information is provided by the Cleveland Clinic and is not intended to replace the medical advice of your doctor or health care provider. Please consult your health care provider for advice about a specific medical condition. For additional health information, please contact the Center for Consumer Health Information at the Cleveland Clinic (216) 444-3771 or toll-free (800) 223-2273 extension 43771. If you prefer, you may visit www.clevelandclinic.org/health/ or www.clevelandclinicflorida.org. This document was last reviewed on: 1/1/1900

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