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Ventral Hernia

Introduction

A ventral hernia is a mass of intestinal tissue that protrudes through a weak spot in the abdominal wall. Ventral hernias can occur at any part of the abdomen but are often known as incisional hernias because they commonly occur at the point of incision after abdominal surgery.

Causes

Ventral hernias are common in patients who have undergone abdominal surgery although this isn't exclusive, and they can also appear in those who have not. If a ventral hernia is a side effect of surgery, the hernia often forms to the side of the incision wound.

Symptoms

Symptoms of a ventral hernia vary and develop over time. In some patients, the only sign will be a noticeable bulge in the abdomen area. This can often be pushed back in, and the hernia won't have any other impact on day-to-day life.

For others, there may be pain and discomfort in the area surrounding the hernia which gets worse with coughing, standing or bending.

Extreme pain in the abdomen or persistent vomiting or nausea may be signs of complications with a ventral hernia, and it's important to seek urgent medical attention.

Diagnosis

A ventral hernia is often diagnosed after a physical exam by a doctor. If a hernia is suspected, further imaging tests such as an ultrasound or CT scan will provide a more thorough look at the abdomen to identify the best treatment options.

Treatment

While a ventral hernia isn't necessarily a medical emergency, surgery will be required to treat the condition. Ventral hernias continue to grow and, if not treated, can develop into an enlarged hernia. Without treatment, an enlarged ventral hernia can lead to increased pain and discomfort; they can fill the abdomen or develop into an incarcerated hernia which poses a severe risk to health.

Surgery

During surgery, the surgeon will manipulate the intestinal tissues back into place and join the abdominal walls back together. In severe cases, the abdominal wall will be reinforced with mesh to strengthen the area. Surgery is generally carried out laparoscopically to minimise recovery time.

Prognosis

The prognosis for a ventral hernia is generally very positive with early medical intervention.  If a ventral hernia isn't treated, it can grow and pose serious risk to other organs if it starts to fill the abdomen. After surgery, there's no guarantee that another ventral hernia won't occur, although, with mesh used to reinforce the abdominal wall, this is less likely.

If not treated, a ventral hernia can lead to an incarcerated hernia where the intestine becomes trapped. This is a medical emergency which requires immediate attention.