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.

