Questions:

  • You have a mass on the abdominal wall, in the upper part or in the inguinal area?
  • You do not had before this mass?
  • You never underwent a parietal surgery?
  • It is painful? There is a sensation of pitching, burning or pressure?
  • It increase in volume, during or after physical activity or prolonged standing up?
  • If you press, it becames smaller?
  • If you cough, you can feel the impulsion on the mass?

If the upper criteria are confirmed, then you may have a parietal hernia.

Localisation: 

-Epigastric hernia (the area between the xiphoid apophyse and upper umbilical area)

-Ombilical or peri-ombilical hernia (on the umbilicus or in next to the umbilicus)

-Inguinal or femoral hernia

-Spigelian hernia (on the lateral part of the rectus abdominis muscle)

Diagnostic:

-Routinely, the diagnostic of a hernia is clinical – by examination

-In case of negative examination (but a positive symptom like in case of a small hernia) or in case of complex herniae, radiological examination is indicated:

  • Ultrasound – accessible, non-invasive, inexpensive and repeatable
  • CT scan – complete evaluation of the abdomen, in case of complex hernias
  • MRI- exceptionally

Treatment:

-The parietal hernia is a mechanic problem, and a surgical intervention is a necessary for the treatment. Treatment by medication it is not effective for this pathology.

-The surgical treatment can be performed by laparotomy, laparoscopy or robotic approach.

-Ordinarily, a non-resorbable mesh is placed, to reinforce the abdominal wall, placed on the posterior side of the abdominal wall or inside the abdominal wall, between the parietal layers.

-An anatomic repair, without the use of a mesh it is equally possible.