Wall hernia

By definition, a hernia is the protrusion of viscera contained in the abdomino-pelvic cavity, through areas of weakness of the abdominal or perineal wall congenitalitously pre-constituted, or through the fascial and muscular layer intended to contain them.

The important features of a hernia are the hernial hole and sac. The hole is the defect in the innermost aponeurotic layer of the abdomen and the sac an evagination of the peritoneum.

The neck of the hernial sac corresponds to the hole. The hernia is external if the sac exits completely through the abdominal wall and internal if it is located within the visceral cavity.

The hernia is reducible when it is possible to return to the abdomen the viscera that has come out and irreducible if this is not feasible. A strangulated hernia is one in which the vascularization of the viscera that has come out is compromised; It occurs in those with small holes and large sacs.

Incarcerated hernia is irreducible, but not necessarily strangulated. A Richter hernia is one in which the sac contains only one side of the wall of the intestine (always antimesenteric).

Different types:

  • Inguinal
  • Crurales
  • Umbilical
  • Epigastric
  • Obturatrices
  • White line or epigastric
  • Spieghel
  • Sciaticas the sciatics
  • Perineales
  • Upper and lower lumbar
  • Diaphragmátics
  • Paraostomals
  • Incisional hernia or eventration: also called incisional or laparotomic hernia. It is defined as the exit of the abdominal continent by default of the non-anatomical wall but produced by a previous surgical intervention, the abdominal contents cross the muscle-aponeurotic wall and is under the skin. Its two main causes are obesity and infection. The treatment will always require prosthesis - mesh either by laparoscopy technique or by conventional open surgery.