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Hernia

Cecile T Robes, D.O. Reviewed 05/2023
 


BASICS

DESCRIPTION

Areas of weakness or disruption of the abdominal wall through which structures can pass 
  • Types

    • Inguinal

      • Direct: acquired; herniation through defect in transversalis fascia of abdominal ...

DIAGNOSIS

HISTORY

  • May observe protrusion through abdominal wall during increased intra-abdominal pressure (Valsalva maneuver or cough)

  • Pain, nausea, vomiting, bloating; relieved with reclining; may sign...

TREATMENT

  • Elective

  • Three options for elective inguinal hernia repair: open, laparoscopic, robotic

  • Elective surgical repair is associated with significantly lower morbidity and mortality.

  • Acute setting

    • Pai...

ONGOING CARE

PATIENT EDUCATION

PROGNOSIS

  • Groin (pediatric): low recurrence rates (<3%) with surgery; may spontaneously...

REFERENCES

1
Orelio CC, van Hessen C, Sanchez-Manuel FJ, et al. Antibiotic prophylaxis for prevention of postoperative wound infection in adults undergoing open elective inguinal or femoral hernia repa...

ADDITIONAL READING

  • Berger D. Evidence-Based Hernia Treatment in Adults. Dtsch Arztebl Int. 2016;113(9): 150–158.

  • Pereira  JA, López-Cano  M, Hernández-Gra...

SEE ALSO

Algorithms: Abdominal Pain, Lower; Intestinal Obstruction; Pelvic Pain 

CODES

ICD10

  • K46.9 Unspecified abdominal hernia without obstruction or gangrene

  • K40.90 Unil inguinal hernia, w/o obst or gangr, not spcf as recur

  • K41.90 Unil femoral hernia, w/o obst or gangrene, not spcf...

CLINICAL PEARLS

  • Inguinal hernias are either direct or indirect:

    • Direct: acquired herniation through defect in transversalis fascia of abdominal wall medial to inferior epigastric vessels

    • Indirect: conge...

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