Ventral Hernia

What is a ventral hernia?

• A ventral hernia is a bulge through a hole in the wall of your abdomen muscles. The bulge may be caused by tissue, fat, or an organ such as your bowels. Three common types of ventral 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.
  
  
• With treatment, your hernia may no longer bulge through your abdomen muscles. It may be easier for you to have a bowel movement and urinate. Treatment may decrease your pain. It may also help prevent your hernia from getting bigger and your bowel from getting twisted.

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 along the incision (cut) where surgery was done. If your wound (surgery area) gets infected, it is more likely to get 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 or strained, pressure may cause a ventral hernia. 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:

• Aging: The muscles in your abdomen get thinner and weaker as you get older.
  
  
• Medical conditions: The muscles of your abdomen may weaken 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 weak abdomen muscles.
  
  
• Weight: Weighing more than your caregiver suggests 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: 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 in your abdomen.
  
  
• 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.
  
  
• Constipation (dry, hard stools).
  
  
• Urinating little or not at all.

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: This test is done so caregivers can see the tissues and organs of your abdomen. Gel will be put on your abdomen and a small sensor will be moved across your abdomen. The sensor uses sound waves to send pictures of your abdomen to 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 see if you have a ventral hernia. He may also see the size of your hernia and what is causing 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: With laparoscopy, your caregiver uses a scope to look inside your abdomen. A scope is a long, bendable tube with a camera on its end. Ask your caregiver for more information about laparoscopy.

How is a ventral hernia treated?

Your caregiver may be able to push your hernia back into your abdomen without surgery. You may also need surgery to treat your hernia.

• If you have surgery, your caregiver may choose an open or laparoscopic technique. During laparoscopic surgery, small cuts are made on your abdomen. Your caregiver then puts a scope and tools through these cuts and fixes your hernia. If your caregiver uses open surgery, he 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 extra fat or tissue. Your caregiver will then stitch up your muscles and abdomen wall. Your caregiver may loosen and spread your muscles to cover the hole surrounding your hernia.
  
  
• Your caregiver may use mesh to help support 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. Your caregiver may cover the hole from a large hernia with a skin flap. A skin flap is tissue or muscle taken from nearby areas of your body, such as your chest. 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 remove extra fluid.

What problems may I have with a ventral hernia?

A ventral hernia may cause a bulge in your abdomen and may change your posture. 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.

How can I help prevent a ventral hernia?

If you weigh more than your caregiver suggests, losing weight may help you to prevent a ventral hernia. Ask your caregiver for a diet that is right for you. Avoiding straining (pushing hard) when you cough or have a bowel movement may also help prevent a hernia. After surgery, other ways to prevent a 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.

When should I call my caregiver?

Call your caregiver if:

• You have a fever (high body temperature).
  
  
• You have vomited (thrown up).
  
  
• You have constipation (dry, hard stools).
  
  
• You urinate little or not at all.
  
  
• After surgery, you have swelling, bleeding, or pus from or near your wound.
  
  
• You have questions or concerns about your hernia, treatment, or care.

When should I seek immediate help?

Seek care immediately or call 911 if:

• Your abdomen is suddenly rigid (very hard).
  
  
• You have pain in your abdomen or back that does not go away, even after taking pain medicine.
  
  
• You have bleeding from your wound that does not stop.
  
  
• You have new trouble breathing.

Where can I find support and more information?

Having a 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. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment.

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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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