Abdominal hernia

Abdominal herniations may be congenital or acquired and come with varying eponyms. They are distinguished primarily based on location and content. 75-80% of all hernias occur in the inguinal region.

Content of the hernia is variable, and may include:

• small bowel loops
• mobile colon segments (sigmoid, caecum, appendix)
• mesenteric fat
• other viscera

Complications predominantly relate to bowel incarceration, strangulation and intestinal obstruction. Diaphragmatic hernias in infancy also may have pulmonary hypoplasia as a complication, if the hernia is large enough.

Classification

1. external herniation:
   • ventral: anterior and lateral abdominal hernias
   • dorsal
   • groin: most common
2. diaphragmatic herniations
3. internal herniations

Subclassification

• anterior abdominal wall herniation:
  • Spigelian hernia
  • parastomal hernia
  • umbilical hernia
  • paraumbilical hernia
  • incisional hernia
  • epigastric hernia
  • Richter hernia: a hernia containing only one wall of a bowel loop and therefore causing no obstruction
  • Maydl hernia
• lumbar herniation: superior and inferior
• groin herniation:
  • direct inguinal hernia
  • indirect inguinal hernia: indirect five times commoner than direct
    • Amyand hernia
  • pantaloon hernia
  • femoral hernia
    • De Garengeot hernia
  • obturator hernia
• diaphragmatic herniation:
  • Morgagni hernia
  • Bochdalek hernia
  • hiatus hernia
• 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
  • a defect in the broad ligament
  • the superior ileocaecal fossa
  • the inferior ileocaecal fossa
  • the retrocaecal fossa
• Littre hernia: a hernia containing a Meckel diverticulum
• pelvic hernia:
  • sciatic hernia
  • perineal hernia