Mr. Ma is a sports enthusiast in his mid-twenties. One day, he observed a swelling in the right groin when he was cycling. It wasn’t really painful. However, he found that a formation of a lump in the groin area, and it failed to return to normal. Mr. Ma was later diagnosed with inguinal hernia while it was made worse with strenuous exercises.

An inguinal hernia is one of the most common surgical conditions, meaning that the viscera in the abdominal cavity slip out of its original position due to an increase in abdominal pressure or weakening of the abdominal wall, and then are being squeezed out of the muscle gap to form a hernia. Hernia can be divided into direct hernia and indirect hernia.

Direct hernia refers to abdominal viscera, such as the small intestine and omentum, protrude outside the abdominal wall through the gap between muscles and fascia; indirect hernia refers to the abdominal viscera enter the inguinal ring. If any signs are found, it is recommended to have a checkup and receive early surgical treatment. The longer a hernia continued, the more serious the damage. It can cause intestinal obstruction or ischemic necrosis, and the risk of complications associated with difficult surgery will increase substantially.


Different circumstances can cause a hernia

A hernia is formed when the muscles and fascia of the abdominal wall become weak or defective due to injury, tissue aging or congenital defects. Once the weakness is formed, the intra-abdominal pressure will tear the muscles or fascia. When part of the internal organs, most likely the intestine, protrudes to the outside through this gap, it is called an abdominal wall hernia.

Common reasons to increase abdominal pressure are: chronic cough, moving heavy objects, holding breath, constipation, pregnancy or obesity. In addition, genetic illnesses can also result in an incomplete inguinal ring closure and a weakened muscular layer, increasing the chance of a hernia formation. Congenital hernia is constructed due to an incomplete inguinal ring closure for a fetus or an infant.


A skinny old lady, Ms. Chen, has been suffering from inexplicable abdomen pain for many weeks with no reason found. Her pain occurred several times a day, little pain each time. Ms. Chen weighs less than 45 kg and she is not at high risk for a hernia. However, the gap of the abdominal wall is wide and lack of enough fat to support, the small intestine can easily fall into the gap. This year’s situation is worse than before, the small intestine did not return to its original natural position and it even protruded to the upper thigh before compressing onto the femoral vein, with symptoms of walking pains and intestinal congestion. After consulting with a surgeon, Ms. Chen was diagnosed with “femoral hernia”. She underwent an urgent surgery, and sutured the femoral ring defect. Her hernia problem lasting many weeks is finally solved.


Anyone has a chance of getting a hernia

The growing number of hernia patients has revealed in younger generations while the living stress in the urban city will increase intra-abdominal pressure easily. People always assume that hernia is an illness can only occur to the elderly and especially men. Although the numbers of male patients are far greater than females, and the elderlies are more than young adults, the incidence of hernia in women and young people shouldn’t be ignored either.

A simple self-checkup as follows:

(1) There is heaviness or mild pain in the affected area plus slight swelling.

(2) The affected area after standing a long time, heavy work or strenuous exercise, coughing or sneezing will be swollen or that can disappear when lying down.

(3) For a serious and painful hernia, a patient will not be able to push a hernia back in.


Hernia treatment requires surgery

As for a baby’s indirect hernia having a chance to heal itself, the only treatment for adult patients is to surgically repair the abdominal wall, because there are no medications or other treatments to cure a hernia. Surgery can be divided into the traditional open surgery method which means cutting from the groin and repairing the abdominal wall by muscles or artificial mesh, and alternatively would be by endoscopic minimally invasive surgery.

Mr. Yang, a longtime smoker, is a site worker who carries heavy loads of sediment and iron sticks every day, resulting in an increase in abdominal pressure. With his smoking habit, it weakens the abdominal wall fascia and the lower abdomen often swell. He often pushes his hernia back in. However, his abdominal pain got worse a few days ago and he couldn’t even go to work. At the hospital, his small intestine was found stuck that causing necrosis and peritonitis. Fortunately, the hernia was amenable to minimally invasive surgical repair, and saved his bowel and relieved his pain.

In recent years, endoscopic minimally invasive surgery has become a new trend of hernia treatment. Endoscopic repair is a one-off solution of bilateral hernia, a total extraperitoneal repair of hernia. Compared to traditional surgery, endoscopic hernia surgery only generates three of the 0.5cm to 1cm scars, with substantial reduction in pain and fast recovery. The success rate of related surgery is also high. Apart from unilateral hernia applications, the benefits of bilateral or recurrent hernia are more pronounced.