Abdominal hernia

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

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

Subclassification

• anterior abdominal wall herniation
  • epigastric hernia
  • incisional hernia
  • interparietal hernia
  • Maydl hernia
  • parastomal hernia
  • paraumbilical hernia
  • Richter hernia: contains only one wall of a bowel loop
  • Spigelian hernia
  • umbilical hernia
• lumbar herniation: superior and inferior
• groin herniation
  • inguinal hernia
    • direct inguinal hernia
    • indirect inguinal hernia: five times commoner than direct
      • Amyand hernia
  • pantaloon hernia
  • femoral hernia
    • De Garengeot hernia
  • obturator hernia
• diaphragmatic herniation
  • Bochdalek hernia
  • hiatus hernia
  • Morgagni 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 ileocecal fossa
  • the inferior ileocecal fossa
  • the retrocaecal fossa
• Littre hernia: hernia containing a Meckel diverticulum
• pelvic hernia
  • perineal hernia
  • sciatic hernia