The abdominal wall is made up of several layers of different types of tissue. From outermost to innermost layer; there is skin followed by fat and connective tissue, fascia, muscle and peritoneum. Each layer has a different tensile strength and collectively they function to protect the contents of the abdomen.
A hernia occurs when there is weakness in the fascia. The fascia is tough, fibrous and the most important layer in preventing protrusion of the abdominal contents. Where there is a weakness in the abdominal fascia the intestines and other abdominal contents produce the classical bulge seen in a hernia.
Most patients complain of mass protruding from the anterior abdominal wall. The common locations for abdominal wall hernias are the groin, umbilicus (navel) and the epigastrium (upper middle portion of the abdomen). The groin is the most common location. Most persons notice a lump which becomes more prominent on standing and disappears on lying down. The swelling may also become more visible on increasing intra-abdominal pressure such as coughing or straining to pass stool.
When a hernia disappears while lying down or the contents can be pushed back into the abdominal cavity, it is described as being reducible. A previously reducible hernia which becomes irreducible is called an incarcerated hernia. An incarcerated hernia is cause for concern and often requires surgical intervention.
In some instances there is aching sensation associated with the hernia. Pain may worsen significantly when a hernia becomes complicated. Complications include incarceration and strangulation. Strangulation is term attributed to hernias that have become incarcerated and the blood supply to the contents of the hernia becomes compromised. This can result in death of a portion of the intestines that can be a life-threatening complication.
Perhaps the most common complication of a hernia is incarceration. This occurs when the contents of the hernia become trapped. The hernia no longer disappears when lying flat. There is an intense pain associated with incarceration. Other symptoms that may occur include vomiting, redness and swelling of the area as well as increased warmth of the swelling.
About this Author
Gary Brown is a medical doctor who has been practicing medicine for the past five years. He has given written and oral presentations on various medical topics for the past three years, primarily on surgical topics. He currently writes articles for LIVESTRONG.