The bowel (small intestine) is held within the abdomen by ligaments and muscles, and the greater omentum membrane (see Diagrams – Gastrointestinal System). Hernias occur when a part of the bowel slips through this support. Symptoms include both discomfort (not usually pain), and a noticeable lump. 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.