Hernia

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Hernia Landing page

Patient Information

Classification

Inguinal hernia
Femoral hernia
Umbilical hernia
Diaphragmatic hernia
Incisional hernia
Others

Differential Diagnosis

CNS Hernia

Brain Hernia
Lumbar Disc Hernia

Diaphragmatic Hernia

Bochdalek Hernia
Morgagni Hernia

Hiatal Hernia

Sliding Hernia
Paraesophageal Hernias

Lumbar Hernia

Petit's Hernia
Grynfeltt's Hernia

Abdominal Hernia

Umbilical Hernia
Epigastric Hernia
Spigelian Hernia
Incisional Hernia
Amyand's Hernia
Richter's Hernia
Parastomal Hernia

Pelvic Hernia

Inguinal Hernia
Obturator Hernia
Perineal Hernia
Incisional Hernia
Femoral Hernia
Sciatic Hernia

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Eiman Ghaffarpasand, M.D. [2], Anmol Pitliya, M.B.B.S. M.D.[3]

Overview

A hernia is “the protrusion of an organ, organic part, or other bodily structure through the wall that usually contains it.[1] Hernias may be congenital or acquired. Based on the protruded body structure and the location of the protrusion, the hernia may be classified into inguinal, femoral, umbilical, diaphragmatic, incisional, and other hernias. Different kinds of hernias, such as central nervous system (CNS), diaphragmatic, lumbar, abdominal, and pelvic hernias have to be differentiated on the basis of clinical manifestations.

Classification

Major classification of hernias in human body.

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Hernia
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
CNS
 
Hiatal
 
Diaphragmatic
 
 
 
 
 
Lumbar
 
Abdominal
 
 
 
 
 
 
 
Pelvic
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Brain hernia
 
Lumbar disc hernia
 
 
Morgagni hernia
 
Bochdalek hernia
 
Petit's hernia
 
Grynfeltt's hernia
 
 
Inguinal hernia
 
Obturator hernia
 
Perineal hernia
 
Femoral hernia
 
Sciatic hernia
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Sliding hernia
 
 
Paraesophageal hernia
 
Umbilical hernia
 
Epigastric hernia
 
Spigelian hernia
 
Incisional hernia
 
Amyand's hernia
 
Littre's hernia
 
Richter's hernia
 
Parastomal hernia
 

Differential Diagnosis

Location Diseases History and Symptoms Physical Examination Laboratory Findings Definition
Neurological GI Neurological GI
Confusion Paresthesia Dysphagia Heartburn Nausea Bowel habits Loss of Consciousness Straight leg raise (SLR) Mass protrusion Tenderness/Rebound tenderness Leukocytosis CRP ESR
CNS Brain hernia[2] + + + - + - + - - - - - - Brain tissue herniation through foramen magnum
Lumbar disc hernia[3] - + - - - - - + - - - - - Nucleus pulposus herniation through annulus fibrosus
Hiatal[4] Sliding hernia - - + + + - - - - - - + - Stomach herniation through diaphragm
Paraesophageal hernia - - + + + - - - - - - - - Esophagus herniation through diaphragm
Diaphragmatic[5] Morgagni hernia - - + - + - - - - - - - - Congenital herniation of stomach through left side of diaphragm
Bochdalek hernia - - + - + - - - - - - - - Congenital herniation of stomach through right anterior side of diaphragm
Abdominal Umbilical hernia[6] - - - - + + - - + + + + - Bowels herniation through umbilicus
Epigastric hernia[7] - - - + + + - - + + + + - Bowels herniation through epigastric abdominal wall
Spigelian hernia[8] - - - - + + - - + + + + - Bowels herniation through lateral abdominal wall
Amyand's hernia[9] - - - - + + - - + + + + - Appendix vermiformis herniation through abdominal wall
Littre's hernia[10] - - - - + + - - + + + + - Meckel's diverticulum herniation through abdominal wall
Richter's hernia[11] - - - - + + - - + + + + + Bowels herniation and strangulation through abdominal wall
Parastomal hernia[12] - - - - + + - - + + + + + Bowels herniation through stoma in the abdominal wall
Pelvic Inguinal hernia[13] - - - - - + - - + + - - - Bowels herniation through inguinal ring
Obturator hernia[14] - + - - - + - - - + - - - Viscera herniation through obturator canal
Perineal hernia[15] - - - - - + - - + + + - - Viscera herniation through pelvic floor
Femoral hernia[16] - + - - - + - - + + - - - Bowels herniation through femoral ring
Sciatic hernia[17] - + - - - + - + - + + - + Viscera herniation through sciatic canal

CNS Hernia

Different types of brain herniation - By User:Delldot, via Wikimedia Commons[18]
Lumbar disc herniation - By BruceBlaus, via Wikimedia Commons[19]

Brain hernia

For more information about brain hernia click here







Lumbar disc hernia

For more information about lumbar disc hernia click here






Diaphragmatic Hernia

Bochdalek hernia

For more information about Bochdalek hernia click here

Morgagni hernia

For more information about Morgagni hernia click here

Hiatal Hernia

Sliding hernia

Different types of hiatal herniation - By Mysid, via Wikimedia Commons[24]

Type I

Paraesophageal hernias

Type II

Type III

Type IV

For more information about hiatal hernia click here

Lumbar Hernia

Lumbar triangles - Zyryab at English Wikipedia, via Wikimedia Commons[25]

Petit's hernia

Grynfeltt's hernia

  • Superior lumbar region has a triangle formed formed medially by the quadratus lumborum muscle, laterally by the internal abdominal oblique muscle, and superiorly by the 12th rib.
  • Grynfeltt's hernia is defined as herniation of retroperitoneal fat through transversalis muscle aponeurosis within the superior lumbar triangle.
  • The mainstay of treatment for lumbar hernias is surgery fixation.[26]


Abdominal Hernia

Umbilical hernia - By Rocco_Cusari, via Wikimedia Commons[27]
Epigastric hernia - By PacoPeramo (Own work), via Wikimedia Commons[28]
Spigelian hernia - By AfroBrazilian (Own work), via Wikimedia Commons[29]
Amyand's hernia: presence of appendix vermiformis (red arrows) in inguinal hernia - By Hellerhoff (Own work), via Wikimedia Commons[30]

Umbilical hernia

For more information about umbilical hernia click here

Epigastric hernia


Spigelian hernia


Incisional hernia


Amyand's hernia


Littre's hernia


Richter's hernia


Parastomal hernia


Pelvic Hernia

Inguinal hernia

For more information about inguinal hernia click here

Obturator hernia

Perineal hernia

Femoral hernia

For more information about femoral hernia click here

Sciatic hernia

References

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  1. Webster's new college dictionary. Boston: Houghton Mifflin Harcourt. 2008. p. 531. ISBN 9780618396016.
  2. Fisher CM (1995). "Brain herniation: a revision of classical concepts". Can J Neurol Sci. 22 (2): 83–91. PMID 7627921.
  3. Schoenfeld AJ, Weiner BK (2010). "Treatment of lumbar disc herniation: Evidence-based practice". Int J Gen Med. 3: 209–14. PMC 2915533. PMID 20689695.
  4. 4.0 4.1 Hyun JJ, Bak YT (2011). "Clinical significance of hiatal hernia". Gut Liver. 5 (3): 267–77. doi:10.5009/gnl.2011.5.3.267. PMC 3166665. PMID 21927653.
  5. "Congenital Diaphragmatic Hernia Overview - GeneReviews® - NCBI Bookshelf".
  6. Gonzalez R, Mason E, Duncan T, Wilson R, Ramshaw BJ (2003). "Laparoscopic versus open umbilical hernia repair". JSLS. 7 (4): 323–8. PMC 3021337. PMID 14626398.
  7. Muschaweck U (2003). "Umbilical and epigastric hernia repair". Surg. Clin. North Am. 83 (5): 1207–21. doi:10.1016/S0039-6109(03)00119-1. PMID 14533911.
  8. 8.0 8.1 Mittal T, Kumar V, Khullar R, Sharma A, Soni V, Baijal M; et al. (2008). "[Not Available]". J Minim Access Surg. 4 (4): 95–8. PMC 2699222. PMID 19547696.
  9. Singal R, Gupta S (2011). ""Amyand's Hernia" - Pathophysiology, Role of Investigations and Treatment". Maedica (Buchar). 6 (4): 321–7. PMC 3391951. PMID 22879848.
  10. Skandalakis PN, Zoras O, Skandalakis JE, Mirilas P (2006). "Littre hernia: surgical anatomy, embryology, and technique of repair". Am Surg. 72 (3): 238–43. PMID 16553126.
  11. Skandalakis PN, Zoras O, Skandalakis JE, Mirilas P (2006). "Richter hernia: surgical anatomy and technique of repair". Am Surg. 72 (2): 180–4. PMID 16536253.
  12. Gillern S, Bleier JI (2014). "Parastomal hernia repair and reinforcement: the role of biologic and synthetic materials". Clin Colon Rectal Surg. 27 (4): 162–71. doi:10.1055/s-0034-1394090. PMC 4226750. PMID 25435825.
  13. 13.0 13.1 Jenkins JT, O'Dwyer PJ (2008). "Inguinal hernias". BMJ. 336 (7638): 269–72. doi:10.1136/bmj.39450.428275.AD. PMC 2223000. PMID 18244999.
  14. Nakayama T, Kobayashi S, Shiraishi K, Nishiumi T, Mori S, Isobe K, Furuta Y (2002). "Diagnosis and treatment of obturator hernia". Keio J Med. 51 (3): 129–32. PMID 12371643.
  15. Levic K, Rosen KV, Bulut O, Bisgaard T (2017). "Low incidence of perineal hernia repair after abdominoperineal resection for rectal cancer". Dan Med J. 64 (7). PMID 28673377.
  16. LUDINGTON LG (1958). "Femoral hernia and its management, with particular reference to its occurrence following inguinal herniorrhaphy". Ann Surg. 148 (5): 823–6. PMC 1450902. PMID 13595543.
  17. Kandpal H, Madhusudhan KS (2010). "Sciatic hernia causing sciatica: MRI and MR neurography showing entrapment of sciatic nerve". Br J Radiol. 83 (987): e65–6. doi:10.1259/bjr/47866965. PMC 3473559. PMID 20197431.
  18. [<"http://www.gnu.org/copyleft/fdl.html">GFDL, <"http://creativecommons.org/licenses/by-sa/3.0/">CC-BY-SA-3.0 or <"https://creativecommons.org/licenses/by-sa/3.0">CC BY-SA 3.0], <"https://commons.wikimedia.org/wiki/File%3ABrain_herniation_types.svg">
  19. Blausen.com staff (2014). "Medical gallery of Blausen Medical 2014". WikiJournal of Medicine 1 (2). DOI:10.15347/wjm/2014.010. ISSN 2002-4436. (Own work) [<"http://creativecommons.org/licenses/by/3.0">CC BY 3.0], <"https://commons.wikimedia.org/wiki/File%3ABlausen_0484_HerniatedLumbarDisc.png">
  20. Stevens RD, Shoykhet M, Cadena R (2015). "Emergency Neurological Life Support: Intracranial Hypertension and Herniation". Neurocrit Care. 23 Suppl 2: S76–82. doi:10.1007/s12028-015-0168-z. PMC 4791176. PMID 26438459.
  21. "Herniated Disc - National Library of Medicine - PubMed Health".
  22. Newman BM, Afshani E, Karp MP, Jewett TC, Cooney DR (1986). "Presentation of congenital diaphragmatic hernia past the neonatal period". Arch Surg. 121 (7): 813–6. PMID 3718216.
  23. Robnett-Filly B, Goldstein RB, Sampior D, Hom M (2003). "Morgagni hernia: a rare form of congenital diaphragmatic hernia". J Ultrasound Med. 22 (5): 537–9. PMID 12751867.
  24. [<"http://creativecommons.org/publicdomain/zero/1.0/deed.en">CC0], <"https://commons.wikimedia.org/wiki/File%3AHiatus_hernia.svg">
  25. <"https://en.wikipedia.org/wiki/User:Zyryab" class="extiw" title="wikipedia:User:Zyryab">Zyryab at <"https://en.wikipedia.org/wiki/" class="extiw" title="wikipedia:">English Wikipedia [<"http://www.gnu.org/copyleft/fdl.html">GFDL, <"http://creativecommons.org/licenses/by-sa/3.0/">CC-BY-SA-3.0 or <"http://creativecommons.org/licenses/by/2.5">CC BY 2.5], <"https://commons.wikimedia.org/wiki/File%3ALumbarTriangle.jpg">via Wikimedia Commons
  26. Başak F, Hasbahçeci M, Canbak T, Acar A, Şişik A, Baş G; et al. (2017). "Lumbar (Petit's) hernia: A rare entity". Turk J Surg. 33 (3): 220–221. doi:10.5152/UCD.2015.2986. PMC 5602318. PMID 28944339.
  27. [<"https://creativecommons.org/licenses/by-sa/2.5">CC BY-SA 2.5], <"https://commons.wikimedia.org/wiki/File%3AErnia_Ombelicale.jpg">
  28. [<"https://creativecommons.org/licenses/by-sa/3.0">CC BY-SA 3.0], <"https://commons.wikimedia.org/wiki/File%3AHernia_epig%C3%A1strica.png">
  29. [<"https://creativecommons.org/licenses/by-sa/3.0">CC BY-SA 3.0 or <"http://www.gnu.org/copyleft/fdl.html">GFDL], <"https://commons.wikimedia.org/wiki/File%3AHernia_spiegheli_01.JPG">
  30. [<"https://creativecommons.org/licenses/by-sa/3.0">CC BY-SA 3.0], <"https://commons.wikimedia.org/wiki/File%3ADe_Garengeot-Hernie_mit_Appendizitis_-_CT_axial_und_coronar_-_001.jpg">
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  35. Malling B, Karlsen AA, Hern J (2017). "Littre Hernia: A Rare Case of an Incarcerated Meckel's Diverticulum". Ultrasound Int Open. 3 (2): E91–E92. doi:10.1055/s-0043-102179. PMC 5462611. PMID 28597002.
  36. Kadirov S, Sayfan J, Friedman S, Orda R (1996). "Richter's hernia--a surgical pitfall". J. Am. Coll. Surg. 182 (1): 60–2. PMID 8542091.
  37. Carne PW, Robertson GM, Frizelle FA (2003). "Parastomal hernia". Br J Surg. 90 (7): 784–93. doi:10.1002/bjs.4220. PMID 12854101.
  38. Bjork KJ, Mucha P, Cahill DR (1988). "Obturator hernia". Surg Gynecol Obstet. 167 (3): 217–22. PMID 3413651.
  39. Stamatiou D, Skandalakis JE, Skandalakis LJ, Mirilas P (2010). "Perineal hernia: surgical anatomy, embryology, and technique of repair". Am Surg. 76 (5): 474–9. PMID 20506875.
  40. Paquet M, Penney J, Boerboom D (2008). "Lateral femoral hernias in a line of FVB/NHsd mice: a new confounding lesion linked to genetic background?". Comp Med. 58 (4): 395–8. PMC 2706040. PMID 18724783.
  41. Rather SA, Dar TI, Malik AA, Parray FQ, Ahmad M, Asrar S (2011). "Sciatic hernia clinically mimicking obturator hernia, missed by ultrasonography: case report". Ulus Travma Acil Cerrahi Derg. 17 (3): 277–9. PMID 21935810.