Hernia's and Fabric supports |Buchanan Orthotics

Anatomy

The organs that are situated within the abdominal cavity are covered with a fine continuous lining membrane called the peritoneal membrane or peritoneum. The part of this membrane that covers the intra (inside) abdominal organs is called visceral peritoneum and the rest of the membrane, which lines the abdominal walls, is called the parietal peritoneum. The peritoneal cavity is the enclosed free space within the belly that is outlined by the parietal and visceral peritoneum.

Abdominal walls – large fibromusclur diaphragm is the roof, pelvis is lower, side walls comprise abdominal muscles and posteriorly lumbar vertebrae and lower ribs.

Contents of the abdomen -

Stomach
Small and large intestines
Liver
Pancreas
Spleen
Kidneys
Urethra
The abdominal aorta and inferior vena cava

Types of Hernias

A Hernia is a protrusion of organs of the abdominal through an abnormal cavity (rupture)

Hernias are named by the site of weakness/location of the rupture, i.e abdominal or inguinal

A Hernia is formed as fat is pushed through a weak point in the muscle and drags the peritoneum out with it. The sac will then enlarge with repeated pressure (any expulsive action e.g. coughing) and allow the intra-abdominal contents to come through.

Adhesions can then form between the peritoneal lining of the sac and the peritoneal surface of the hernia, preventing the hernia from being reduced. Complications include abdominal pain, intestinal obstruction and strangulation.

Ventral Hernias

Epigastric hernia

Hernia in the Epigastrium section of the abdomen, which is below the sternum but above the belly button.

Spigelian hernia

Hernia through the Spigelian aponeurosis next to the rectus abdominal muscle. Common hernia in sports people. Most common group is over 50's active men.

Inguinal hernia

Direct inguinal hernia

A through the weakened posterior wall of the canal, usually at the medial inguinal fossa of peritoneum.

Indirect inguinal hernia

Hernia which passes obliquely along the inguinal canal. This type of hernia can ultimately become a scrotal hernia. Both result in a painful dragging sensation and pain in the groin.

Umbilical hernia

Hernia through the umbilical region, most common in infants, usually painless.

Incisional hernia

A hernia at the sight of previous surgery, along a scar.

Parastomal hernia

A colostomy is an opening of the colon through the abdominal wall when the bowel is unable to function in a normal way. An ileostomy is the opening of the latter part of the small intestine (the ileum) to the abdomen instead of the colon. These patients will now have an aperture (stoma) on the abdominal wall. A hernia can develop directly over the stoma site due to the weakness created in the abdominal wall.

Causes in adults

Obesity
Multiple pregnancies
Previous abdominal surgery
Fluid in the abdominal cavity (ascites)
Long-term peritoneal dialysis to treat kidney failure – CAPD Continuous ambulatory peritoneal dialysis due to fluid staying in the peritoneal cavity during the day