Abdominal hernias/herniae may be congenital or acquired and come with varying eponyms. They are distinguished primarily based on type, location and content.
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Epidemiology
75-80% of all hernias are inguinal ref.
Pathology
Content of the hernia is variable, and may include:
small bowel loops
mesenteric fat
other viscera, e.g. stomach, bladder, ureter, kidney
Types
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external herniation
ventral: anterior and lateral abdominal hernias
dorsal
groin: most common
diaphragmatic herniation
internal herniation
Subtypes
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anterior abdominal wall herniation
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miscellaneous
Richter hernia: contains only one wall of a bowel loop
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indirect inguinal hernia: five times commoner than direct
pantaloon hernia (combined direct and indirect inguinal herniae)
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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
the superior ileocaecal fossa
the inferior ileocaecal fossa
the retrocaecal fossa
Littre hernia: hernia containing a Meckel diverticulum
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pelvic hernia
Complications
Complications predominantly relate to bowel incarceration, strangulation, and intestinal obstruction. Large diaphragmatic hernias in infancy may be complicated by pulmonary hypoplasia.
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