Consumer Information

Ventral Hernia

GENERAL INFORMATION:

What is a ventral hernia?

A ventral hernia is a bulge through the wall of your abdomen (stomach). The bulge may be caused by tissue, fat, or an organ such as your bowels. Three common types of abdomen hernias are incisional, epigastric, and spigelian. You may have an incisional hernia in places where you have had a surgical cut. An epigastric hernia occurs above your bellybutton. A spigelian hernia occurs on the side of your abdomen.
Your caregiver may be able to push your hernia back into your abdomen. Other hernias may require surgery. Surgery may help prevent your hernia from getting bigger and your bowel from getting tangled. You may be in less pain. You may have less trouble urinating or having bowel movements. Your stomach may not have bulging and you may feel better about your appearance. You may return to work and your other normal daily activities faster than without surgery.

What may cause a ventral hernia? You may get a ventral hernia when the muscles of your abdomen become weak. Some causes of weakness in the wall of your abdomen may include the following:

Past surgeries: If you have had abdomen surgery, you may get a hernia where your caregiver cut you (your incision). If your wound (surgery area) becomes infected, then it is more likely to become weak. You may also get a hernia next to a stoma. A stoma is an opening in your abdomen that drains stool from your bowels.
Muscle strain: If your abdomen muscles are weak, then increased pressure may cause a hole in your abdomen wall. Heavy lifting can cause muscle strain. In women, the stretching of the abdomen during pregnancy can also cause muscle strain.
Your body: You may be born with weak abdomen muscles. You may have a ventral hernia at birth or you may develop it sometime during your life.

What may increase my risk for a ventral hernia? Factors that make it more likely for you to have a ventral hernia may include any of the following:

Age: The muscles in your abdomen become thinner and weaker as you get older.
Medical conditions: The muscles of your abdomen may become weaker if you have certain medical conditions. These conditions may include diabetes (increased blood sugar), lung disease, and cancer. Your muscles may become weak if your body does not make enough collagen (a special protein). Ask your caregiver for more information about conditions that may cause you to have weak abdomen muscles.
Smoking: If you smoke, it may be harder for you to heal after a surgery. If you take longer to heal, then your abdomen muscles may stay weak.
Weight: Weighing more than your caregiver advises may put too much strain on your muscles and make them weak. You may also get weak abdomen muscles if you lose a lot of weight very quickly. Your muscles may also become weak if your body does not get enough nutrition.
Medicine: Some medicines, such as steroids, may increase your chances of getting a ventral hernia.

What are the signs and symptoms of a ventral hernia? You may have one or more of the following:

A bulge or swelling in your abdomen.
Nausea (you feel like you need to throw up).
Pain in your abdomen.
Very bad back pain.
Trouble standing up straight.
Trouble having bowel movements.
Trouble urinating.

How is a ventral hernia diagnosed? Your caregiver will look and feel for a bulge in your abdomen. He may ask you to lie down with your legs bent. He may also ask you to cough while standing up. You may need any of the following:

Abdominal ultrasound: An abdominal ultrasound is a test that is done to see inside your abdomen. Sound waves are used to show pictures of your abdomen on a TV-like screen.
Computed tomography (CT) scan: This is also called a CAT scan. A special x-ray machine uses a computer to take pictures of your abdomen. A CT scan may help your caregiver confirm that you have a ventral hernia. He may also see the size of your hernia and what is inside of it. You may be given dye before the pictures are taken. The dye may help your caregiver see the pictures better. People who are allergic to shellfish (lobster, crab, or shrimp) may be allergic to some dyes. Tell your caregiver if you are allergic to shellfish or have any other allergies.
Laparoscopy: Your caregiver may do a laparoscopic surgery to look for problems in your abdomen. This is a procedure to look inside your abdomen. If your caregiver finds a hernia, then he may then use laparoscopy to do your surgery. A special scope is put into your abdomen through a small cut. A scope is a long, bendable tube with a camera on its end. You may have one or more cuts near your belly button. Ask your caregiver for more information about laparoscopy.

How is a ventral hernia treated?

A ventral hernia is treated with surgery. Your caregiver may choose open or laparoscopic surgery. During laparoscopic surgery, your caregiver makes small cuts on your abdomen and uses a laparoscope to fix your hernia. During an open surgery, your caregiver will cut open your abdomen to fix your hernia. Your caregiver will find your hernia and cut open the tissue surrounding it. He may remove what is inside the tissue, such as extra fat, tissue, or skin. Your caregiver will then stitch the muscles and abdomen wall. Your caregiver may also cover the hole by cutting and spreading your muscles.
Your caregiver may use mesh to help support your the wall of your abdomen. Mesh may be made of man-made or natural material. Mesh may be placed in front of, on, or inside the lining of your abdomen. If you do not have enough tissue, your caregiver may use a skin flap. A skin flap is tissue or muscle taken from nearby areas to help repair a large hernia. If you have a stoma, your caregiver may need to close it and make a new one. Before your caregiver stitches you up, he may put in a drain to decrease any extra fluids.

How can I help prevent another ventral hernia after having surgery? Some ways that may help prevent another ventral hernia include the following:

Do not lift heavy objects until your caregiver says that it is OK.
You may need to wear a support belt or girdle. Ask your caregiver for more information about support clothing.
Your caregiver may suggest that you do exercises to strengthen your abdomen. Swimming and walking may also help. Ask your caregiver for an exercise plan. Do not exercise more than your caregiver says is OK.
Ask your caregiver when it is OK to return to your normal daily activities.
Follow your caregiver's advice about losing weight. If you are overweight, ask your caregiver for a diet that is right for you.
Avoid straining (pushing too hard) when you cough, urinate, or have a bowel movement. Ask your caregiver for ways to avoid straining.

What problems may I have with a ventral hernia? A ventral hernia may cause a bulge in your abdomen. It may change your posture and you may feel bad about your appearance. You may get pain in your abdomen and your back. You may get an infection near your hernia. You may find it hard to urinate or have a bowel movement. Part of your bowel may become trapped or twisted. The trapped bowel may not get enough blood and the tissue may begin to die. Your blood may become infected and you may die.

When should I call my caregiver? Call your caregiver if:

You have a fever (high body temperature).
You have vomited (thrown up).
You have trouble urinating.
You have trouble having a bowel movement.
You have swelling, bleeding, or pus near your stitches.
You have questions or concerns about your condition, treatment, or care.

When should I seek immediate help? Seek care immediately or call 911 if:

Your abdomen is rigid (very hard).
You have abdominal pain or back pain that does not go away, even after taking pain medicine.
You have bleeding that does not stop.
You have trouble breathing.

Where can I find support and more information? Having a ventral hernia may be hard for you. You may have a hard time accepting how your abdomen looks. Talk to your caregiver, family, or friends about your feelings. Contact the following for more information:

American College of Surgeons
633 N. Saint Clair St.
Chicago, IL 606113211
Phone: 1-312-2025000
Phone: 1-800-6214111
Web Address: http://www.facs.org

CARE AGREEMENT:

You have the right to help plan your care. To help with this plan, you must learn about your health condition and how it may be treated. You can then discuss treatment options with your caregivers. Work with them to decide what care may be used to treat you. You always have the right to refuse treatment.

The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

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