Incisional hernia: what it is, symptoms, causes and how to treat

Incisional hernia is a type of hernia that occurs at the scar site of surgery on the abdomen. This happens because of excessive tension and inadequate healing of the abdominal wall. Due to the cutting of the muscles, the abdomen wall is weakened, and it makes the intestine, or any other organ below the incision site, easier to move and press the scar site, leading to the formation of a small swelling in that region.

Although incisional hernias are a relatively common complication in anyone who has abdominal surgery, they are more common in people with obesity, who have had a wound infection, or who have a previous health problem, such as diabetes, lung disease, or any illness. that increases the pressure inside the abdomen.

Whenever there is a suspicion that an incisional hernia is developing after surgery, it is very important to go to the hospital or consult the doctor who performed the surgery, so that the hernia can be evaluated and treatment started as soon as possible.

Main symptoms

The most common symptom of incisional hernia is the appearance of a swelling next to the scar from abdominal surgery, however, it is also common for other associated symptoms to appear, such as:

• Pain or discomfort at the hernia site; Nausea and vomiting; Fever below 39ºC; Difficulty urinating; Changes in intestinal transit, constipation or diarrhea.

The incisional hernia usually appears 3 to 6 months after the surgery, but it can appear before that period. In addition, it is also customary for the hernia to be more easily observed when standing or gaining weight, and may even disappear when sitting and relaxed.

How to confirm the diagnosis

In most cases, the incisional hernia can be diagnosed by a general practitioner or surgeon, just by observing the symptoms and assessing the clinical history. Thus, it is advised that whenever there is a suspicion of hernia, go to the Family Health Center or make an appointment with the surgeon who performed the surgery.

Possible causes and how to avoid

Incisional hernia can happen in any case where there is a cut in the muscles of the abdominal wall and, therefore, it is relatively common after surgery on the abdomen. However, there are some factors that seem to increase the risk of developing this type of hernia, such as:

• Having an infection at the scar site; Being overweight or obese; Being a smoker; Using some medicines, especially immunosuppressants or steroids; Having other health problems, such as diabetes, kidney failure or lung diseases.

The best recommendation to reduce the risk of developing an incisional hernia, in addition to avoiding the risk factors, is to wait the time recommended by the doctor before starting activities that can put pressure on the belly, including having a pregnancy.

How the treatment is done

The treatment of incisional hernia should always be evaluated together with the doctor, depending on the general health status, anatomy and location of the hernia. However, the type of treatment most used is surgery, in which the doctor can open the scar again or make small cuts in the skin to insert a net that helps to strengthen the muscles of the abdominal wall, preventing the organs from passing and making weight on top of the scar.

Generally, larger hernias are more difficult to treat and, therefore, need classic surgery, in which the scar is opened again. Minor hernias, on the other hand, can be treated with laparoscopy, where the doctor makes small cuts around the hernia to repair it, without needing to open the scar from the previous surgery again.

Possible complications

When not properly treated, the incisional hernia can end up strangling the intestine, which means that there is less blood with oxygen reaching the part that is trapped. When this happens, a serious death situation of the intestinal tissues can develop.

In addition, even if the hernia is small in size, over time, it is possible that it will increase in size, worsening symptoms and making treatment more difficult.