What is hernia, abdominal rupture? What are its causes, symptoms and treatment?

What is hernia, abdominal rupture? What are its causes, symptoms and treatment?
Photo source: Getty images

The streak is a common disease and occurs in newborns, children, men, women and the elderly. The problem is a weakened abdominal wall.


Strip, or the rupture on the abdomen, and from the neighbors also a hernia. The basis of the abdominal band is the weakening of the abdominal wall.

The contents of the abdominal cavity, organ, organs or other tissues and structures are then extruded through the abdominal wall.

However, in general ...

Hernia means that there has been a pathological transfer of the organ or organs, tissues from the place of natural deposition to another. An example is the arching of the intervertebral disc - disc hernia, spinal hernia.

The risk of hernia is mainly complications resulting from pathological movement. 

We know several types and forms of ruptures.

Some sufficient traceability of a conservative approach. Others require immediate surgery.

If the treatment of a "jammed" abdominal rupture is neglected or delayed, the course of the disease can be unnecessarily complicated. Dying and the onset of inflammation of the abdominal organs and tissues is a significant risk to human health or life. 

The abdominal wall is made up of several muscles.

The front part consists of the muscle m. rectus abdominis. It is divided by the linea alba, which is a ligament strip running from the sternum to the navel. 

Below is the muscle m. pyramidalis. Three muscles are placed on the sides, namely m. obliquus externus, m. obliquus internus a m. transverse abdominis.

In these places, for example, there are ruptures in the area of ​​the linea alba, namely the abdominal epigastric hernia and the  umbilical , ie  umbilical rupture . In the lower area there is a weakness break.

This is just a brief look at the division of games.

From an anatomical point of view, it is a weakened abdominal wall. The peritoneum bows into place of weakness (peritoneum). Subsequently, in addition to the peritoneum, the intestine, but sometimes also the stomach, uterus or ovary, can most often arch over this weakened defect.

The game room describes:

  • the gate breaks, ie a weakened place in the abdominal wall
  • a bag that forms the peritoneum
  • content, this may be the intestine, stomach or other organ and tissue

The most common hernia is the groin rupture. Its contents are mostly the small intestine or part of it. It is then referred to as enterocele.

Alternatively, it may be part of the content of the omentum, the membrane that covers the abdominal organs, referred to as the epicocele

In girls and women, the contents of the hernia may include the ovarieswhen it is referred to as the ovary.

The content of the diaphragm of the diaphragm can be, for example, the stomach, liver, spleen and also the kidney. Hiatal hernia is a type of rupture in which a part of the stomach gets through the gate in the diaphragm.

The table shows the division of game rooms according to several properties

  • congenital hernia  - already at birth, newborns often have umbilical ruptures
  • acquired hernia  - during life, the most common is a weakness rupture
  • external ruptures - visible externally on the abdominal wall
  • internal ruptures , for example in the abdominal cavity, but also pelvic, lumbar, diaphragmatic, such as hiatal hernia
Presence of a bag
  • right hernia - with present bag
  • fake hernia - without bag
  • free hernia - repairable, can be "corrected" pushed back through the goal 
  • irreplaceable hernia , if this is not possible
    • hernia incarcerata  - with intestinal tick 
    • hernia accreta - bag and contents increases 
    • hernia permagna - hernia too large

We know several forms of rupture by  location, an example is:

  • inguinal - inguinal hernia - bar groin
  • umbilical - umbilical hernia - stripe on the navel
  • epigastric, abdominal hernia above the navel
  • thigh - femoral
  • in the scar - hernia in cicatricae - it forms in the place of the surgical scar, which is a natural area of ​​weakening of the abdominal wall
  • hiatus in the diaphragm
  • and other

The most common cases are ...

Umbilicalumbilical hernia is a common hernia in newborns. It therefore has an innate, congenital origin.

It occurs in approximately 10-20% of newborns. 
Approximately 3-5% of full-term infants, 
30% of preterm infants.

The advantage in this case is that in most cases it closes within two years. The special gluing of the game room is especially helpful.

Conversely, acquired forms of umbilical hernia are more common in women. The main factor is pregnancy, which increases the pressure in the abdominal cavity.

Strip in pregnancy for higher intra-abdominal pressure.

Furthermore, we can encounter this type of hernia for abdominal tumors, tumors, but also for ascites, which is swelling of the abdomen.

In umbilical hernia, the navel is typically arched

Weakened-inguinal rupture is the next most common species and represents acquired hernias.

The approximate prevalence of hernias in the population is 10%, of
which about 75% are weak. 

The lobe hernia can be on both sides, ie bilaterally (15%), or either to the right (60%) or to the left (25%).

It is typically manifested by a hemispherical bulge in the groin area.

In boys, arching can penetrate the sac.
In girls, an ovary may appear in the rupture bag.

Stripe above the navel ...

Hernia epigastrica, is called a rupture, located in the midline of the abdomen above the navel.

In this case, they are rather smaller hernias, however, they usually occur in higher numbers. Their content is often fat in obese people, but also the omentum.

Lane after surgery ...

Herniation in the scar is also a special type of rupture. The abdominal wall after the operation is healed by a scar. 

A risk factor for the development of these hernias is the surgical wound, which has become infected and healed for a long time. It is also obesity and BMI over 25, but also age over 60 years.

 Are you asking about complications?

The risk of hernia is mainly the constriction of the contents of the bag with subsequent non-bleeding of the organ or tissue

Disruption of the vascular supply when the intestine is blocked will cause a part of the intestine not to bleed to the intestinal obstruction - ileus. Prolonged non-bleeding leads to death, ie necrosis.

The problem can continue with inflammation when the peritoneum is sensitive to the local state of bloodlessness. And peritonitis, an inflammation of the peritoneum, is a serious complication.

Herniation can be complicated by:

  • strangulation of the intestine or other tissue with consequent circulatory disorder
  • inflammation
  • growth
  • intestinal obstruction - disorder of the intestinal passage, ileus


What are the causes of the lane and why is it formed?

The basis is the weakening of muscles and fascia.
Through this weakened place, the defect, due to the increased pressure in the abdominal cavity, the tissue, intestine, arches

The rupture gate and the weakened part of the abdominal wall can expand further. And the bigger the defect, the greater the risk of complications.

There are innate and acquired forms of hernias. And risk factors are similarly shared.

The internal risk factors are:

  • innate genetic predisposition and heredity of abdominal wall weakness
  • previous rupture on the other side of the body (at the groin band) or another species 
  • male gender in the groin band
  • female gender for umbilical cord
  • age, in the elderly, the abdominal wall weakens with age
  • disorders of collagen metabolism
  • anatomical conditions

The acquired risk factors are:

  • low or high BMI
  • obesity and overweight
  • ascites - swelling of the abdomen
  • surgery and wound, mainly secondary to healing with an inflammatory complication
  • pregnancy and childbirth
  • injury
  • muscle stretching

And whether the defect is congenital or the cause behind the problem, the streak may not develop at all and may be asymptomatic for a long time

However, other risk factors contribute to the start of the problem.

Other risk factors are, for example:

  • increase in abdominal pressure
  • cough, especially chronic cough and sneezing
  • strenuous bowel movements
    • chronic constipation
    • pushing on the stool
  • lifting a heavy load and an object
  • poor lifestyle and low fiber in the diet
  • smoking


The main symptom of hernia is the arching of the bag with its contents through the goal, ie a weakened defect of the abdominal wall. 

The outer form of the rupture manifests itself as a hemispherical bulge. Which can be the only manifestation.

The bulge can be easily pushed. However, over time, as the intra-abdominal pressure increases, it bows again. Alternatively, it flattens in bed. 

It is referred to as a reducible species.

The opposite is the irreducible hernia, it is a bigger problem, as it remains arched even for trying to push it. 

There is also a risk of enlarging the break in the goal. There is also an increased risk of strangulation, jamming of the defective content. 

He thus professionally refers to such stuck hernias as hernia incarcerata. The severity of the condition is a restriction of blood supply. After some time without bleeding, the affected tissue or organ dies.

And this is a condition that endangers a person's health and life.

In the game room we can encounter the following manifestations :

  • bulging, lumps on the abdominal wall
    • on one or both sides of the groin
    • arched navel in umbilical hernia
  • the bulge can be pushed in, in an uncomplicated form
    • eventually, the arching decreases in bed
    • incompressible bulge if the course is more severe
  • hernia increases over time
  • enlargement of the hernia with increased pressure in the abdomen
    • cough
    • lifting a heavier object
  • rupture pain
  • swelling
  • solidification in the rupture zone
  • reddening of the skin up from bluing
  • stomach ache
  • pain according to the location of the hernia, or shooting pain
    • into the groin
    • into the scrotum (short) in men
    • into the abdomen
    • into the genitals
    • to the back
    • to the lower limb
    • chronic pain in the pelvis
  • bloated belly
  • digestive problem 
  • anorexia
  • frequent and excessive gagging
  • heartburn
  • feeling sick (vomiting)
  • weakness and fatigue
  • increase in body temperature to fever in inflammation
  • difficulty breathing
  • a small child may be restless, crying


Diagnosis is based on anamnesis, evaluation and examination of the abdomen. In the anamnesis, one indicates a bow that resembles a game room with its properties.

The doctor evaluates the form of the rupture. Plus, evaluate the risks and appropriate treatment.

Imaging methods are important, namely USG / SONO, X-ray, or CT or MRI

The basic laboratory examination of the blood will be supplemented, if a surgical solution is necessary.

How do I know I have a lane?

The symptoms of the streak may appear suddenly or gradually. They cause varying degrees of pain and difficulty. The following table tells you which symptoms and symptoms are characteristic of the bar and which are not.

Symptom / speech Presence at the lane
Visible bulging and swelling on the abdomen or groin sensitive to touch Very common
Abdominal pain due to physical exertion, coughing or movement Very common
Chronic pelvic pain Frequent
The lump in the abdomen or groin, visible most when coughing, disappears when lying down Frequent
Weakness, pressure or burning sensation in the abdomen or groin Uncommon


The course of the strip depends on the form, extent and location

Breaks are long-term and you don't even know about them. Then the course is called asymptomatic - asymptomatic.

The other side is hernias, which arise suddenly and also have an acute course. Depending on the location and extent, there are also associated difficulties. 

Bowing above the level of the abdomen may increase with cough or increased physical exertion or pressure on the stool.

The strip can be easily pushed.

Over time, however, the defect and weakening of the abdominal wall may increase.
A team rises and the risk of complications.

The intensity of difficulties increases, there is pain, pressure or burning in the abdomen, the pain may radiate into the groin, or weakness and anorexia may be added.

The bowel jam in the break is manifested by a sudden deterioration and difficulty, abdominal pain is acute, sharp. Constipation, nausea and even vomiting are associated. 

Herniation cannot be pushed back. It is an irreplaceable form.

The risk is the death of part of the organ, the intestine in the bag. Necrosis is a risk for the possibility of rupture of the intestine

The contents are poured from the ruptured intestine into the abdominal cavity.
Peritonitis begins.
Man is acutely endangered in health and life.

Hernia incarcerata is an indication for surgical treatment.

In young children, there is usually restlessness and crying. The navel is concave, may change color and swell.

A professional examination should be sought if the symptoms extend to an increase in body temperature to fever, swelling and hardening in the hernia area, if the skin is red to bluish.

Recurrence of hernia is also a risk
What does it mean? 
Approximately 0.5-5% of people experience band re-formation.

Herniation in children

Even in childhood, hernia is one of the relatively common problems. In this period, it is mainly an innate form.

Umbilical hernia usually resolves itself within two years, without the need for a surgical solution. The abdominal muscles strengthen and the hernia disappears.

Streaks in newborns and babies are relatively common.

It is necessary to monitor the break and changes visible from the outside.

An examination is necessary if the child is suddenly :

  • restless
  • he can't calm down and he cries
  • the navel is extruded, arched
  • cannot be pushed
  • the color of the skin changes, it is blue to dark

Normally, hernias bow down when they cough or sneeze, but also when they put pressure on their stools. 

For older children and when lifting heavier objects.

You ask:

Can lifting heavy things cause a streak?

The cause of the streak in children is multifactorial and is usually caused by a weakening of the abdominal wall, often due to innate genetic predisposition. 

However, not every child has a streak after lifting something heavier.

A weakness rupture can already be a bigger problem that will need to be addressed surgically. Of course, the doctor decides.

The strip can be easily pushed back and is not painful. The child has no difficulties.

The risk, as in adulthood, is jamming of the intestine or other organ or tissue. In girls and the ovary, its vessels and in boys, the restriction of blood flow to the testis, the sac.

However, beware of manifestations such as:

  • changes in the child's behavior
  • cry
  • nausea to vomiting
  • diarrhea or constipation
  • stopping the departure of winds, gases
  • sudden pain - it gets worse, even when pushing on the bar
  • the bar cannot be pushed
  • color change in the bar area
  • swelling
  • increase in body temperature to fever

 Weak fractures are more common in boys than in girls.

A break in the groin is cured surgically. He has no alternative treatment.

How it is treated: Hernia

How is the streak treated? Monitoring and surgery

Show more

fshare on Facebook

Interesting resources

  1. Fitzgibbons RJ, Forse RA (February 2015). "Clinical practice. Groin hernias in adults". The New England Journal of Medicine372 (8): 756–63.
  2. Domino FJ (2014). The 5-minute clinical consult 2014 (22nd ed.). Philadelphia, Pa.: Wolters Kluwer Health/Lippincott Williams & Wilkins. p. 562. ISBN 9781451188509
  3. Roman S, Kahrilas PJ (October 2014). "The diagnosis and management of hiatus hernia". BMJ349: g6154.
  4. Vos T, Allen C, Arora M, Barber RM, Bhutta ZA, Brown A, et al. (GBD 2015 Disease and Injury Incidence and Prevalence Collaborators) (October 2016). "Global, regional, and national incidence, prevalence, and years lived with disability for 310 diseases and injuries, 1990-2015: a systematic analysis for the Global Burden of Disease Study 2015". Lancet388 (10053): 1545–1602. 
  5. Wang H, Naghavi M, Allen C, Barber RM, Bhutta ZA, Carter A, et al. (GBD 2015 Mortality and Causes of Death Collaborators) (October 2016). "Global, regional, and national life expectancy, all-cause mortality, and cause-specific mortality for 249 causes of death, 1980-2015: a systematic analysis for the Global Burden of Disease Study 2015". Lancet388 (10053): 1459–1544. 
  6. "Hernia". MedlinePlus. U.S. National Library of Medicine. 9 August 2014. 
  7. Öberg S, Andresen K, Rosenberg J (2017). "Etiology of Inguinal Hernias: A Comprehensive Review". Frontiers in Surgery4: 52. 
  8. Mihailov E, Nikopensius T, Reigo A, Nikkolo C, Kals M, Aruaas K, et al. (February 2017). "Whole-exome sequencing identifies a potential TTN mutation in a multiplex family with inguinal hernia". Hernia21 (1): 95–100. 
  9. Sezer S, Şimşek N, Celik HT, Erden G, Ozturk G, Düzgün AP, et al. (August 2014). "Association of collagen type I alpha 1 gene polymorphism with inguinal hernia". Hernia18 (4): 507–12. 
  10. Gong Y, Shao C, Sun Q, Chen B, Jiang Y, Guo C, et al. (March 1994). "Genetic study of indirect inguinal hernia". Journal of Medical Genetics31 (3): 187–92. 
  11. Nigam VK (2009). Essentials of Abdominal Wall Hernias. I. K. International Pvt Ltd. p. 6. ISBN 9788189866938
  12. "Inguinal hernia". The Mayo Clinic
  13. Lee HK, Park SJ, Yi BH (2010). "Multidetector CT reveals diverse variety of abdominal hernias". Diagnostic Imaging32 (5): 27–31. 
  14. Goers TA, Klingensmith ME, Chen LE, Glasgow SC (2008). The Washington manual of surgery. Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins.