Dr. Antonio Privitera

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About Hernias: Meaning & Definition

Hernia meaning: The word ‘Hernia” comes from the Latin: hernia “rupture”, related to hira “intestine’. Interestingly enough, the word is often misspelt, and “hernis” seems to be a very common search word on the web.

Hernia definition: A hernia is the protrusion of a viscus through the wall of the cavity that contains it. Most common hernias are abdominal wall hernias: inguinal, femoral, umbilical, paraumbilical, epigastric, spigelian, lumbar, obturator and incisional hernias.

The anatomy of an inguinal hernia

What Is An Inguinal Hernia?

An inguinal hernia is defect in the posterior wall of the inguinal canal (transversalis fascia) that allows passage of fat or intra-abdominal content through it. Hernias that are lateral to the inferior epigastric vessels and enter the deep inguinal ring are called indirect, while direct hernias are between the epigastric vessels and the umbilical folds. While indirect hernias usually consist of intra-abdominal content (omentum, bowel), direct hernia usually are composed of pre-peritoneal fat. Inguinal hernias are superior and medial to the pubic tubercle, while femoral hernias are inferior and lateral. The inguinal canal in males contains the spermatic cord, while in females the round ligament is present. Attention needs to me paid during an inguinal hernia repair to the spermatic cord structures not to cause damage to the testicle.

What Are The Causes of Hernia?

A general structural tissue abnormality leading to weakness has been shown in people with hernias. However, contributing  factors are chronic increases of abdominal pressure (heavy lifting, chronic cough, constipation with straining, etc.

What are the hernia symptoms?

Pain and discomfort and the presence of a swelling more obvious with increase of abdominal pressure (coughing, sneezing, straining) are the most common symptoms. The discomfort usually worsens during the day and subsides when resting or lying down. A swelling that becomes hard and unable to be pushed back in or increasing pain radiating to other parts of the abdomen are worrisome signs of incarceration or strangulation that require emergency treatment.

Types Of Hernia

How are Hernias Diagnosed?

Clinical examination is usually enough to diagnose hernias. A defect can be palpated and the hernia is made more obvious asking the patient to cough or perform Valsalva maneuver. Examination of the inguinal canal is best performed by introflection of scrotal skin with the index finger and palpating the posterior wall for presence of defects. Asking the patient to cough, an impulse will be felt. An ultrasound scan can be performed in case of doubts, and a CT scan is useful in large ventral hernias for planning of approach prior to surgery.

How are Hernias Repaired?

It is usually recommended that a mesh (prosthetic material) is used to repair hernias to reduce recurrence rates. A mesh allows to reinforce weak tissues and also to avoid the tension that is obtained by closing the edges of the hernia defect with simple sutures. Tension is the main cause of recurrence. Laparoscopic techniques are widely used to repair hernias, however, when abdominal defects are large (>10  cm) some surgeons prefer to perform an open approach.

Free Consultation for Hernias

A proctology service in Dubai and Abu Dhabi not only for Hernia Treatments, but also for many other diseases is currently operating in Dubai London Hospital, Aster Hospital, American Hospital. Currently, Dr. Antonio Privitera is offering a free consultation for hernias in the same hospital in Dubai and Abu Dhabi.

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