Dr. Charles "Pat" Davis, MD, PhD, is a board certified Emergency Medicine doctor who currently practices as a consultant and staff member for hospitals. He has a PhD in Microbiology (UT at Austin), and the MD (Univ. Texas Medical Branch, Galveston). He is a Clinical Professor (retired) in the Division of Emergency Medicine, UT Health Science Center at San Antonio, and has been the Chief of Emergency Medicine at UT Medical Branch and at UTHSCSA with over 250 publications.
Hernias are bulges of material, usually contained in a body cavity, that protrude through the cavity's wall. These bulges of material may consist of almost any tissue or organ type and may occur almost anywhere in the body. An individual may have multiple hernias of the same or different types. The most frequent type of hernia and the type most people are familiar with are those that are caused by bulges of intestine or abdominal fatty tissue that protrude through different areas in the abdominal cavity. However, many people are confused by the term hernia because the type of hernia which usually precedes the term “hernia” is not clearly defined to them. The following is a list of many hernia types and what they indicate.
The following is a list of major and some minor types of hernias that may occur in individuals:
Inguinal hernias: These occur on both sides of the lower abdomen where the male testicles descend before birth. Two-thirds of all hernias are inguinal and occur most often in men. They can be termed direct (goes through the floor of inguinal canal) or indirect (goes through the internal inguinal ring). Indirect hernias have a higher tendency to progress to nonreducible or incarcerated types of hernias (see below), so they should be surgically repaired soon after diagnosis.
Ventral (incisional hernias): These hernias occur in the abdomen at the site of a previous surgery.
Femoral hernias: These hernias appear just above the groin crease and occur most frequently in women after pregnancy and childbirth.
Umbilical hernias: These occur near the belly button (navel) and often occur in infants; some may resolve in children aged 3 to 4, but others may persist. Also, they can occur at any age.
Epigastric hernias: These hernias occur in the upper abdomen at or above the belly to the breastbone; they occur more frequently in men than women.
Hiatal hernias: These occur through the diaphragm into the chest cavity; these hernias are not usually visible nor can they be palpated.
Acquired and congenital hernias: Acquired hernias occur during life activities while straining muscles (for example, childbirth or post surgeries) while congenital are hernias present from birth (most children with hernias have congenital hernias).
Reducible and nonreducible hernias: Reducible hernias can be flattened out (reduced) by laying down and/or applying some pressure to the bulge while nonreducible hernias cannot be flattened out using the same laying down/pressure technique. A nonreducible hernia is usually painful and may develop into an incarcerated hernia (see below) and people with these hernias need to be seen quickly, usually by a surgeon.
Incarcerated hernias (also termed strangulated or obstructed hernias): These hernias are nonreducible hernias that have trapped the bulge of tissue (usually intestinal tissue) so tightly that the blood supply is compromised and can result in tissue death and gangrene. This type of hernia requires emergency surgery to release the tissue and repair the hernia.
The above hernia types are fairly common. Other common herniations occur in intervertebral disks that can cause back and leg pain. However, there are still other hernia types that are less common. As stated previously, hernias may appear almost anywhere in the body. There are at least 20 other named types of hernias. If a person knows what hernias are, it becomes much easier to understand that the types are usually named according to the location, tissue, or organ involved and the severity of the herniation.