The bowel (small intestine) is held within the abdomen by ligaments and muscles, and the greater omentum membrane (see Diagrams โ€“ Gastrointestinal System).ย  Hernias occur when a part of the bowel slips through this support.ย  Symptoms include both discomfort (not usually pain), and a noticeable lump.ย  It can happen in the groin, in the middle of the belly, or even off to one side.

Problems occur when the hernia gets trapped (“incarcerated”), & then its blood supply cut off (“strangulated” in medical terms).  Pain begins, the area is very tender, leading to nausea and vomiting.  Without surgery, the bowel can die; germs in dead bowel then cause massive infection (with fever), and death.

It’s usually easy to identify hernias on exam, certainly if they’re causing complications.  But occasionally a mild hernia comes & goes, so when the patient comes to see us, we can’t find it.  An ultrasound is useful in that case.

Hernias without any symptoms can be operated on whenever.  Anyone with a hernia can benefit by seeing a surgeon.  That doesn’t mean immediate operation, but rather a discussion of possibilities and options.

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