A ventral hernia occurs when intestines or other organs protrude through a defect in the abdominal wall. These hernias are very common; according to the "Sabiston Textbook of Surgery," more than 150, 000 ventral hernia repairs are performed in the United States annually. In contrast to cases of groin or inguinal hernias, in which it may be a reasonable alternative to watch the progress of the hernia before undertaking surgery, ventral hernias have higher complication rates and generally require repair.
Expansion of the Hernia
If left alone, the hernia has potential to expand through the growing defect in the abdominal wall. This has a couple of dangerous implications. First, the organs will reside outside the abdominal cavity, which may contract. This will prevent surgical repair until the abdominal cavity is dilated. Second, the organs can place stress on the surrounding skin, cutting off its blood supply.
Incarceration
Incarceration of the hernia means that the intestines become wrapped around themselves or otherwise trapped through the defect in the abdominal wall. The incarceration can obstruct the intestines, preventing the passage of food. Symptoms include pain, nausea, vomiting and other similar problems. This is a medical emergency and is common enough to warrant surgery.
Strangulation
Strangulation occurs after incarceration of the hernia. When a hernia becomes strangulated, its blood supply is cut off. This can lead to death of the intestinal segment that is involved, perforation of the intestinal wall with leakage of its content into the bowel, and life-threatening infections. For these reasons, the "Sabiston Textbook of Surgery" recommends that most ventral hernias be repaired.
References
- "Sabiston Textbook of Surgery"; Townsend et al; 18th Ed 2007
- Columbia University Medical Center: Department of Surgery: About Hernias: Hernia Complications
