Hernias

This is an inguinal hernia! No, not the penis, the lump above and on the left of it.

What is a hernia?!

A hernia is a protrusion of an organ through a hole in the wall of the cavity that usually contains it.

Are they common?

Yes, they are very common. By far the most common type of hernia is the Inguinal Hernia. There is a nice explanation of the types below:

• Inguinal Hernia - Basically, there is a congenital weakness of the inguinal canal. This sometimes herniates. Very common, and more common in women. Presents as a lump in the groin an inch above the pubic synthesis.
• Femoral Hernia - A bit lower than an inguinal canal one, much more common in women, and much more prone to strangulation!
• Umbilical Hernia - More common in black male babies. They often resolve on their own. Can also occur in obese women.
• Incisional Hernia - Occur after surgery, leading to expanding scar tissue. Can be very difficult to treat surgically, since the problem is in the scar tissue, and mending it just makes more scar tissue.
• Hiatus Hernia - Where the stomach herniates through the diaphragm. Commonly presents with reflux.

Management

Most hernias are reducible. In other words, they can be pushed back into position. So an inguinal hernia lump can be pushed back inside. In an reducible hernia, you don't treat it, you just leave it, since you are more likely to make the problem worse than better.

Some hernias are irreducible. This means that they can't be pushed back. Sometimes this occurs for a few minutes, sometimes it is a permanent situation. In this case, you need to sort out the hernia, because there is a much higher risk of progression to...

Medical Emergency - Strangulated hernia. A hernia can become incarcerated, trapped so that the blood supply cannot get through. This is a surgical emergency, since it can lead to necrosis of bowel.