Figure 3-6. Incisional (ventral) hernia.
b. Etiology. As with other hernias, there is a weakness in the wall which
encloses an organ. Perhaps the person was born with the weakness or exertion such
as lifting heavy objects or straining over long periods of time caused an opening which
allowed the organ to bulge out.
c. Complications. The abdominal hernia as well as the inguinal hernia can
become incarcerated or strangulated. Remember that an incarcerated hernia is one in
which the portion of the organ which has bulged through a weakness in a body cavity
wall cannot get back into the body cavity. Substances which normally flow through the
intestine cannot do so. A strangulated hernia is an incarcerated hernia with one more
problem; not only can the intestinal flow not pass through the intestine but the blood
supply in intestinal tissues is cut off. This condition can lead to intestinal tissue death
and death of the patient if the trapped intestine is not surgically remove and intestinal
flow started again by connecting the remaining intestine. It is impossible to distinguish
between an incarcerated hernia and a strangulated hernia; therefore, treat a hernia that
could be either of these as a medical emergency. Signs and symptoms of these
hernias include constant pain, elevated white blood count, tachycardia (abnormally fast
heart beat), and tenderness in spot.
d. Symptoms. The hernia may visible as an area which bulges out. Also, each
time the patient lifts a heavy object or strains in any way, he may feel pain.
e. Treatment. There are two possible treatments for abdominal hernia: surgery
and mechanical reduction (trusses). Surgery is usually the treatment of choice. Use of
a truss was once common practice for those who wanted to avoid hernial surgery. A
truss was a belt and a pressure pad used to keep a hernia in place or to prevent it from
becoming larger. The use of trusses is not common today because a truss does not
cure the hernia. The prolonged pressure can lead to pressure sores and the breakdown
of underlying tissues. These conditions make surgical repair of the hernia more difficult
later. Additionally, even though the patient wears a truss, his hernia can get larger as
well as become incarcerated or strangulated.