Abdominal hernias (herniae also used) may be congenital or acquired and come with varying eponyms. They are distinguished primarily based on location and content. 75-80% of all hernias are inguinal.
Content of the hernia is variable, and may include:
- small bowel loops
- mobile colon segments (sigmoid, cecum, appendix)
- mesenteric fat
- other viscera
Complications predominantly relate to bowel incarceration, strangulation, and intestinal obstruction. Large diaphragmatic hernias in infancy may be complicated by pulmonary hypoplasia.
Classification
- external herniation
- ventral: anterior and lateral abdominal hernias
- dorsal
- groin: most common
- diaphragmatic herniation
- internal herniation
Subclassification
-
anterior abdominal wall herniation
- epigastric hernia
- incisional hernia
- port site hernia
- interparietal hernia
- parastomal hernia
- paraumbilical hernia
- Spigelian hernia
- umbilical hernia
- rectus sheath - rectus sheath hernia
- miscellaneous
- Maydl hernia
- Richter hernia: contains only one wall of a bowel loop
- lumbar herniation
-
groin herniation
-
inguinal hernia
- direct inguinal hernia
- indirect inguinal hernia: five times commoner than direct
- pantaloon hernia (combined direct and indirect inguinal herniae)
- Busoga hernia
- femoral hernia
- obturator hernia
-
inguinal hernia
- diaphragmatic herniation
-
internal herniation: an uncommon cause of bowel obstruction
- the left paraduodenal fossa (fossa of Landzert): most common
- the right paraduodenal fossa (fossa of Waldyer)
- the foramen of Winslow (lesser sac)
- a hole in the mesentery (transmesenteric)
- a hole in the transverse mesocolon
- broad ligament hernia
- the superior ileocecal fossa
- the inferior ileocecal fossa
- the retrocecal fossa
- Littre hernia: hernia containing a Meckel diverticulum
- pelvic hernia