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

  • 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

  • ​superior lumbar hernia

  • inferior lumbar hernia

• groin herniation

  • inguinal hernia

    • direct inguinal hernia

    • indirect inguinal hernia: five times commoner than direct

      • Amyand hernia

    • pantaloon hernia (combined direct and indirect inguinal herniae)

    • Busoga 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

  • broad ligament hernia

  • the superior ileocecal fossa

  • the inferior ileocecal fossa

  • the retrocecal fossa

• Littre hernia: hernia containing a Meckel diverticulum

• pelvic hernia

  • perineal hernia

  • sciatic hernia